bluuebunny/crossref_metadata_2025_split huggingface dataset:
PECULIARITIES OF TREATMENT OF ARTERIAL HYPERTENSION IN PATIENTS WITH METABOLIC SYNDROME
Authors: Gaspar Ludovít , Mesarosova Dasa 
Published: June 2022

Objective:
The Metabolic syndrome (MS) is characterized by a collection of risk factors, that increase the chance of developing cardiovascular complications. Classifications and definitions of the MS indicate that on its pathogenesis, as well as on resulting complications, five fundamental componets do participate – obesity, insulin resistance, endothelial dysfunction, aggregation of other components and diurnal pattern loss.
The aim of our study was to detect changes in diurnal trait depending on the presence of metabolic syndrome.

Design and method:
Under the conditions of hospitalization we examined 56 persons with the presence of metabolic syndrome (average age 66 years) and 51 persons without metabolic syndrome (average age 61 years). To control the effectiveness of antihypertensive treatment, we used ambulatory blood pressure monitoring (ABPM) (Meditech and Marquette-Hellige devices) with oscillometric blood pressure measurement.

Results:
In the group of patients with MS dipping was present in 37.5 %, while in the group without MS in 57.1 %. Non dippers and risers where in the group with MS present in 58.9 %, while in the group without MS in 33.3 %. Monotherapy in patients with MS was present in 19.6 %, while in the group of patients without MS in 36.4 %. Four-combination of antihypertensives was in the group with MS in 23.2 %, while in patients without MS in 9.1 %. The mean blood pressure values in the group with MS were 134/79 mmHg and in the group without MS 132/83 mmHg. These blood pressure values were justifiably achieved due to differences in antihypertensive medication – monotherapy versus combination therapy.

Conclusions:
ABPM plays an important role in monitoring the effectiveness of antihypertensive treatment. In patients with MS achieving blood pressure targets is often a therapeutic problem, which usually requires a combination of three or more antihypertensives. Also presence of orthostatic hypotension, as a manifestation of cardiovascular autonomic neuropathy, may affect the treatment of arterial hypertension. Frequent loss of diurnal pattern in patients with MS is also of prognostic significance.
SEX DIFFERENCES IN ARTERIAL FUNCTION IN OBESITY: THE FAT-ASSOCIATED CARDIOVASCULAR DYSFUNCTION STUDY
Authors: Eikås John Glad , Gerdts Eva , Midtbø Helga , Cramariuc Dana , Kringeland Ester A. 
Published: June 2022

Objective:
Obesity has been associated with increased arterial stiffness, but sex differences in this association have been less explored. We compared different measures of arterial stiffness between women and men with obesity and free of clinical cardiovascular disease participating in the FAT associated dysfunction (FATCOR) study.

Design and method:
We performed a cross-sectional analysis in 351 women and 233 men with mean age 48 ± 9 years and body mass index (BMI) 32 ± 4 kg/m2. Arterial function was assessed by applanation tonometry as aortic augmentation pressure (AP), augmentation index (AIx), and pulse wave velocity (PWV). Covariables of arterial function were identified in linear regression in the total cohort and in sex-specific analyses. Multivariable models were adjusted for age, body height, BMI, 24-hour systolic blood pressure (BP), heart rate (HR), diabetes, serum low-density lipoprotein, estimated glomerular filtration rate (eGFR), and smoking habit.

Results:
Women had higher AP and AIx, and lower PWV compared to men (all p < 0.005). Women also had higher BMI and HR, while men had higher BP (all p < 0.05). In the total study cohort, female sex remained independently associated with higher AP (=0.35) and AIx (=0.45) after adjustment for significant confounders including age, BP, HR, and eGFR (all p < 0.02). Male sex was associated with higher PWV (=0.15) independent of age, BP, HR, and smoking habit (all p < 0.02). In sex-specific analyses, higher AP was associated with higher age and BP, and lower HR in women (all p < 0.001), and with higher age, BP, and eGFR in men (all p < 0.01). Similarly, higher AIx was related to higher age and BP, and lower BMI and HR in women (all p < 0.05), and with higher age and eGFR in men (all p < 0.02). Finally, in women, higher PWV correlated with higher age, BP, and HR (all p < 0.05). In men, higher PWV was associated with higher age, HR, and with smoking habit (all p < 0.005).

Conclusions:
In obese subjects free of clinical cardiovascular disease, measures of arterial stiffness differed between women and men. AP and AIx were higher in women, while PWV was higher in men, independent of important confounders like age and BP.
EFFECTS OF WEIGHT LOSS ON VASCULAR FUNCTION AND CENTRAL HEMODYNAMIC PARAMETERS IN OBESE INDIVIDUALS WITH POOR CARDIOVASCULAR HEALTH
Authors: Cunha Michelle , Mattos Samanta , Klein Marcia , Neves Mario 
Published: June 2022

Objective:
To evaluate the effect of weight loss on vascular function and central hemodynamic parameters in obese individuals with different classifications of cardiovascular health according to the American Heart Association

Design and method:
Prospective intervention study with patients of both genders, aged 40 to 70 years and body mass index (BMI) > = 30 and < 40 kg/m2, instructed to follow a low-calorie diet (reduction of 800 kcal/day) for 8 weeks. They were submitted to clinical and nutritional assessment, analysis of central hemodynamic parameters using Mobil-O-Graphâ, and the endothelial function by post-occlusive reactive hyperemia using Laser Spectre Contrast Image. The patients (n = 71) were divided into two groups, iCVH (n = 31) and pCVH (n = 40).

Results:
The patients had a mean age of 51 years, 79% and 73% were female in iCVH and pCVH, respectively. After 8 weeks of nutritional intervention, there was a reduction in body mass index (iCVH, 34.2 ± 2.5 vs 32.9 ± 2.6 kg/m2, p< 0.001) (pCVH, 33.8 ± 2.8 vs 32.8 ± 2.7 kg/m2, p < 0.001), waist-height ratio (iCVH, 0.62 ± 0.05 vs 0.60 ± 0.01, p = 0.005) (pCVH, 0.62 ± 0.04 vs 0.60 ± 0.04, p = 0.001) and fat weight (iCVH, 36 ± 7 vs 32 ± 6 kg, p = 0.013) (pCVH, 35 ± 6 vs 33 ± 6 kg, p < 0.001). Compared to the baseline, peripheral systolic blood pressure (BP) (126 ± 14 vs 119 ± 15mmHg, p = 0.001), diastolic BP (80 ± 9 vs 76 ± 8mmHg, p = 0.004) and pulse pressure (46 ± 10 vs 42 ± 10mmHg, p = 0.025) was significantly decreased only in pCVH. In this group, central systolic pressure (117 ± 14 vs 112 ± 11mmHg, p = 0.014) was also decreased. Pulse wave velocity did not change in iCVH (7.2 ± 0.9 vs 7.2 ± 1.0m/s, p = 0.926) and was reduced in pCVH (7.5 ± 1.1vs7.2 ± 1.0m/s, p = 0.080), although not reaching statistical significance. In this same group, cutaneous vascular conductance in post-occlusive reactive hyperemia (1.07 ± 0.27 vs 1.17 ± 0.28, p = 0.003) increased compared to the baseline.

Conclusions:
In this sample of obese patients, the intervention with a low-calorie diet resulted in improvement of peripheral and central pressure and functional vascular parameters more evident in subjects with poor cardiovascular health.
METABOLIC SYNDROME IN POLYCYSTIC OVARY SYNDROME TUNISIAN WOMEN
Authors: Smaoui Fatma , Chaabouni Khansa , Elleuch Aida , Boudaya Mariem , Mezghani Chema , Chaabene Kais , Frikha Madiha , Ayadi Fatma 
Published: June 2022

Objective:
Polycystic ovary syndrome (PCOS) is known to reproduce metabolic syndrome (MS) features. This association seems to be heterogeneous.
To investigate the profile of MS in patients with PCOS in Tunisia.

Design and method:
Our study was conducted on women diagnosed with PCOS in 2020 and age matched controls. PCOS and MS diagnosis were made according to the Rotterdam criteria and the definition of the International Diabetes Federation (IDF) respectively. Biochemical tests were analysed via an automated method (Cobas-Roche).

Results:
Our study was conducted on 96 patients and 108 controls. The median age in patients was at 25 years vs 27 in controls. Only 19.7% of patients met the criteria of MS. However, in controls the prevalence of MS was 12.6%. All MS criteria were more prevalent in PCOS patients compared to controls. We observed in decreasing order: android fat distribution, followed by elevated fasting glucose and decreased HDLc, followed by hypertension, and finally hypertriglyceridemia.

Conclusions:
In the literature, the prevalence of MS in PCOS was estimated between 22% and 42%. The relatively low prevalence of MS in Tunisian PCOS could be explained by age and geographical heterogeneity of MS distribution. Since, these patients are likely at risk of chronic comorbidities we suggest initiating a specific management.
ASSOCIATION BETWEEN PERIRENAL ADIPOSE TISSUE, METABOLIC PARAMETERS AND BLOOD PRESSURE PROFILE IN PATIENTS WITH ABDOMINAL OBESITY
Authors: Azimova Makka , Azimova Marina , Blinova Natalia , Zhernakova Yuliy , Chazova Irina 
Published: June 2022

Objective:
Perirenal adipose tissue is considered as new marker of cardiometabolic risk, as particular visceral fat depot, can leads to metabolic decoders and organ damage. The aim of study to assess the effects of perirenal adipose tissue on metabolic parameters and 24-hours profile of blood pressure in patients with abdominal obesity.

Design and method:
The study included 104 patients (37,5% - men, 62.5% - women), mean age 38.59 ± 6.09 years with abdominal obesity (waist circumference (WC) > 80 cm in women and > 94 cm in men), without cardiovascular diseases and diabetes mellitus. Perirenal adipose tissue (PAT) volume was measured by multislice computed tomography (MSCT) (ToshibaAquillion 640, Japan). Blood sampling and measurements of lipid levels, fasting glucose, insulin, HOMA index, 24-hour ambulatory blood pressure monitoring were performed.

Results:
PAT volume was associated with WC (r = 0,70; p < 0,05) in participants with abdominal obesity. A positive correlation was found between PAT and triglyceride (r = 0,35; p < 0,05), insulin (r = 0,37; p < 0,05), HOMA-index (r = 0,38; p < 0,05); creatinine (r = 0,30; p < 0,05) and a negative correlation - with HDL-cholesterol (r = -0,40; p < 0,05). There was no association between PAT and LDL-cholesterol. PAT was associated with day (r = 0,29; p < 0,05) and night (r = 0,39; p < 0,05) systolic blood pressure and with day (r = 0,30; p < 0,05) and night (r = 0,30; p < 0,05) systolic blood pressure.

Conclusions:
PAT is associated with metabolic disorders, insulin resistant index and blood pressure profile in patients with abdominal obesity.
MATERNAL SALT INTAKE AND MICROVASCULAR ENDOTHELIAL FUNCTION DURING THE THIRD TRIMESTER OF HEALTHY PREGNANCY
Authors: Vulin Martina , Metzger Ana-Maria , Magusic Lucija , Drenjancevic Ines , Jukic Ivana , Sijanovic Sinisa , Juric Iva , Muller Andrijana , Stupin Ana 
Published: June 2022

Objective:
Even in healthy individuals, high-salt (HS) loading leads to endothelial dysfunction, a hallmark of cardiometabolic diseases, independently of the changes in blood pressure (BP). Still, the effect of the amount of daily salt intake during healthy pregnancy on maternal endothelium-dependent vascular reactivity has not yet been investigated. Thus, this study aimed to assess the effect of the amount of daily salt intake during third trimester of pregnancy on maternal microvascular reactivity to stimuli in healthy pregnant women.

Design and method:
The present study was designed as a cross-sectional study in which all the data for each pregnant woman were obtained at one-time point between 37 and 40 weeks of gestation. Daily salt intake was estimated based on 24-h urinary sodium excretion using appropriate formula [1-g salt (NaCl) = 393.4 mg Na = 17.1 mmol Na]. Microvascular endothelium-dependent vasodilation in response to vascular occlusion (PORH), iontophoresis of acetylcholine (AChID) and local heating (HEAT), as well as endothelium-independent vasodilation in response to iontophoresis of sodium nitroprusside (SNP) was assessed by Laser Doppler flowmetry (LDF).

Results:
Preliminary results of the present study involve data obtained from 27 healthy pregnant women. According to the amount of daily salt intake, pregnant women were divided in low-salt (LS, < 5 g of salt/day, N = 4), normal-to-high salt (NHS, 5.0–7.5 g of salt/day, N = 12) and high-salt (HS, > 7.5 g of salt/day, N = 11) group. All pregnant women were normotensive, and BP values did not differ between groups. HEAT was significantly lower in HS compared to LS and NHS group, while PORH and AChID tended to be lower in HS compared to LS and NHS group, but without statistical significance. SNPID did not significantly differ between the groups. There was weak to moderate negative correlation between daily salt intake and functional markers of microvascular endothelium-dependent vasodilation (PORH, AChID and HEAT).

Conclusions:
The amount of daily salt intake significantly affects maternal endothelium-dependent microvascular reactivity during third trimester of healthy pregnancy, i.e. the increased salt intake significantly reduces the endothelium-dependent dilatation of the skin microcirculation, especially responses mediated by nitric-oxide (NO).
FEASIBILITY, ACCEPTANCE AND SAFETY OF A HOME BASED TELEMONITORING STRATEGY IN WOMEN WITH POSTPARTUM HYPERTENSION. INTERIM ANALYSIS OF THE SWISS REGISTER FOR WOMEN WITH PPHT
Authors: Socrates Thenral , Wenker Céline , Blaschke Christina , Vischer Annina , Meienberg Andrea , Mayr Michael , Hösli Irene , Lapaire Olav , Burkard Thilo 
Published: June 2022

Objective:
Postpartum hypertension (PPHT) is elevated blood pressure that persists or develops after pregnancy. PPHT affects 10% of all pregnancies and is the most common cause for re-hospitalization. PPHT stems from hypertensive disorders of pregnancy (HDP) which include preexisting and gestational hypertension, preeclampsia (PE), and eclampsia. Although the National Institute for Health and Care Excellence suggests tight controls there is no global consensus. The aim of the current analysis was to determine the feasibility, acceptance, and safety of a home-based telemonitoring strategy in women with PPHT.

Design and method:
Enrollment began in June 2020 at the University Hospital Basel Maternity Ward and Hypertension Clinic. Those with preexisting hypertension, HDP, and de novo PPHT were enrolled. A nested substudy allowed the participants to choose either a home-based telemonitoring approach or standard of care. The telemonitoring strategy was defined as a smartphone application provided by the study team or a programmed spreadsheet to report blood pressure followed by telephone consultations. Standard of care was hospital-based visits after discharge. All participants were assessed three months postpartum with a standardized hospital visit including a 24-hour blood pressure measurement, blood, biomarker and urine analysis.

Results:
112 participants were prospectively enrolled from Jun 2020. Mean age was 33.5 ± 5.1 years, 8.9% had preexisting hypertension, 26.8% gestational hypertension, 55.4% preeclampsia (PE) 0.9% eclampsia, 6.9% HELLP and 17.9% had de novo PPHT. Family history of cardiovascular disease was seen in 50%, 8.9% had a family history of PE, and 20.5% were high risk for PE. The most common type of delivery was C-Section (74%), mean hospital stay was 6 days (±2.88) and IUGR was seen in 75.9% of the newborn babies. 98% of participants choose a home-based strategy. At 3 months, 97.8% reported a feeling of safety with home-based telemonitoring and would use the same approach in the future. There were zero re-hospitalizations due to high blood pressure.

Conclusions:
This analysis demonstrated that a home-based telemonitoring plan is feasible, well-accepted, and safe in terms of re-hospitalizations or blood pressure complications. This is relevant for the direct postpartum period and even more pertinent during a pandemic.
TREATMENT OF PERSISTENT RENAL DYSFUNCTION AFTER PREECLAMPSIA WITH BENAZEPRIL: A RANDOMIZED, DOUBLE-BLIND TRIAL
Authors: Pechère-Bertschi Antoinette , Dufey Anne , Wuerzner Gregoire , Jaques David , Burnier Michel , Tejada Begonia Martinez De , Seigneux Sophie De , Ponte Belén 
Published: June 2022

Objective:
Preeclampsia increases the long-term cardiovascular and renal risk of women. Guidelines recommend to closely follow pre-eclamptic women in the post-partum (PP), but there is no consensus about treatment in women with early persistent kidney damage and high blood pressure after delivery. Objectives: to assess the efficacy of benazepril in improving surrogate markers of renal function of the PP period.

Design and method:
This was a double blind randomized controlled trial (benazepril 10 mg or placebo) in women with persisting microalbuminuria and/or blood pressure > 140/90 mmHg, and/or ongoing antihypertensive treatment 6–8 weeks PP. The primary outcome was to assess the efficacy of benazepril on GFR, albuminuria, CRP and blood pressure at 3 and 6 months.

Results:
We included 120 preeclamptic women, mean age was 34.1 ± 5.4 y, BMI before pregnancy was 25.7 ± 5.4 kg/m2; 6 weeks after delivery mean GFR was 114.5 ± 17.6 ml/min/1.73m2, microalbuminuria/urine creatinine ratio was 9.4 ± 13.9 mg/mmol, CRP was 9.3 ± 14. mg/L, SBP was 130.6 ± 13.1, and DBP was 90.4 ± 11.4 mmHg. At 3 months (resp. 6 months) postpartum, microalbuminuria and blood pressure improved in both groups but both parameters were significantly lower with benazepril than with placebo group (Table).

Conclusions:
Our study shows that benazepril was effective to improve renal surrogates in women having suffered from preeclampsia. The clinical benefits of maintaining the treatment beyond 6 months remain to be demonstrated.
WOMEN WITH HYPERTENSIVE STATES OF PREGNANCY FOLLOW IN NEPHROLOGY: CHARACTERISTICS AND EVOLUTION AFTER DELIVERY
Authors: Guimil Paula Delgado , Herranz Ester Domenech , Gonzalez Esther Rubio , Testillano Lucia Martin , Pujol Javier Relea , Perez Jose Maria Portoles 
Published: June 2022

Objective:
Descriptive analysis of the profile of pregnant women who develop some type of hypertensive disorders of pregnancy (HDP). Review the possible factors involved in its appearance, know the maximum proteinuria at the time of diagnosis and how it evolves after delivery, and the medication used for its control.

Design and method:
An observational, prospective study of pregnant women with HDP referred to nephrology consultation after hospital discharge post-delivery in 2020.

Results:
We recruited 55 patients with a mean age of 35.5 years, BMI of 26.12, 18.2% met obesity criteria. 54.7% were primiparous and of the multiparas, 17.4% had had previous HDP. 18.9% were in vitro pregnancies, 5.7% were twins and 47.2% required cesarean section. The average weight of the newborn was 2858.82 gr. 94.3% of the women were not diabetic and 18.9% developed gestational DM. 86.8% started breastfeeding.
Regarding the type of HDP (Graph 1): 81% presented a clinical profile of pre-eclampsia (PE) / eclampsia; 3.8% chronic hypertension, 13.2% chronic hypertension with superimposed PE and 1.9% gestational hypertension. The diagnosis of PE was in 90.6% of the cases due to the appearance of proteinuria, 1.9% due to plaquetopenia, 1.9% due to neurological alterations and 5.7% due to only BP figures > 160/110 (Graph 2). No acute renal failure was recorded. The average proteinuria was 1345.52 mg/gr, which decreased to 65.62 mg/gr after one month of treatment, persisting with proteinuria in only 18.8% of the patients.
The average number of antihypertensive drugs taken at the moment of the diagnosis was 1.77, and 0.9 at 10 days. 100% go home with medication but in the 10-day control, 28.3% no longer needed any. As concerns the evolution of medication intake, see (Graph 3).

Conclusions:
Hypertensive disorders during pregnancy are the most frequent medical complication, affect 5–10% of pregnant women and continue to be an important cause of fetal and neonatal morbidity and mortality throughout the world, due to low birth weight or prematurity. Maternal complications can range from acute kidney failure to HELLP syndrome, liver failure, cerebral edema, seizures, or death
PLASMA STEROID PROFILE IN WOMEN WITH FIBROMUSCULAR DYSPLASIA - THE ARCADIA-GYN STUDY
Authors: Aniszczuk-Hybiak Anna , Florczak Elzbieta , Dobrowolski Piotr , Teliga-Czajkowska Justyna , Prejbisz Aleksander , Dobrowolska-Redo Agnieszka , Was Joanna , Rucinska Karolina , Lutynska Anna , Kosinski Przemyslaw , Grabowska-Derlatka Laretta , Januszewicz Magdalena , Papaccoggli Marco , Persu Alexandre , Januszewicz Andrzej 
Published: June 2022

Objective:
Fibromuscular dysplasia(FMD) mostly affects women in reproductive age. It has been suggested that FMD might be related to female hormone levels or contraceptive use. Therefore, the aim of the ARCADIA-POL substudy ARCADIA-GYN was to perform detailed, prospective obstetrics and gynaecological evaluation of women with FMD.

Design and method:
We enrolled in the ARCADIA-GYN study 42 women with FMD, ages between 18–46 years old and 45 age-matched healthy, normotensive women who have regular menstruation. By means of LC-MS/MS we analysed plasma steroid profile: estrogen, progesterone, testosterone, aldosterone, cortisol, 18-oxo-cortisol, 18-hydrocortisol, cortisone, 11-deoxycortisol, 21-deoxycortisol, corticosterone, 11-deoxycortisone, progesterone, 17-OH progesterone, pregnenolone, androstenedione, DHEA, DHEA-SO4. Blood samples in all subjects were collected in luteal phase while women stayed without any hormonal contraceptive. FMD was diagnosed based on ARCADIA-POL protocol as published previously. No signs of arterial lesions and/or disturbances in blood flow were found in Doppler duplex evaluations of carotid and renal arteries in control subjects.

Results:
42 patients with FMD (34.2 ± 8.1years), predominantly with renal FMD, were compared to 45 healthy, normotensive women (34.0 ± 5.4years; p = 0.88). Hypertension was diagnosed in 88.1% (37) women with FMD. In women with FMD we found lower plasma levels of progesterone (5.1 inter quartile range [IQR] 2.0–8.2 vs 7.6 IQR 3.3–12.5ng/ml;p = 0.017),testosterone (0.20 IQR 0.15–0.28 vs 0.25 IQR 0.18–0.36ng/ml; p = 0.036), DHEA (3.6 IQR 2.6–4.3 vs 4.5 IQR 2.9–6.6ng/ml;p = 0.012), DHEAS04 (1167 IQR 819–1535 vs 1579 IQR 1197–1980ng/ml;p = 0.04) and 11-deoxycortisol (0.09 IQR 0.05–0.12 vs 0.14 IQR 0.09–0.18ng/ml;p = 0.002) as compared to control group. There were no significant differences in other analyzed hormones. There were no differences in steroid profile evaluations between patients with unifocal and multifocal FMD.

Conclusions:
Women with FMD as compared to healthy controls are characterized by hormonal alterations including lower plasma progesterone level. Taking into consideration previous findings of abnormal balance between estrogen and progesterone receptors in renal artery samples of FMD our results suggest that female hormonal disturbances may have a role in FMD development.