bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATIONS BETWEEN EPICARDIAL FAT AND LEFT VENTRICULAR GEOMETRY IN YOUNG NON-OBESE HYPERTENSIVES
Authors: Khomova Irina , Khramkova Anastasia , Shavarova Elena , Ezhova Nadezhda , Shkolnikova Ekaterina , Maksimova Maya , Aryutina Olga , Kobalava Zhanna 
Published: June 2022

Objective:
Epicardial adipose tissue (EAT) has been considered as a marker of cardiovascular risk. Previously association between the EAT volume with the insulin resistance index, metabolic parameters and emodelling parameters of the left heart was observed in young obese people with abdominal obesity.

Aim:
to evaluate the relations between epicardial adipose tissue thickness (EAT) with metabolic parameters and left ventricular geometry in young non-obese individuals with hypertension comparing to normotensive subjects.

Design and method:
30 young non-obese subjects with untreated essential hypertension (HTN) diagnosed by office blood pressure (BP) measurements by Korotkoff method and/or ambulatory BP monitoring (ESH, 2018) were included as study group (mean age - 23 ± 3 yrs, 100% were male, mean BMI 26 ± 6 kg/m2, office SBP/DBP 138 [130; 171] / 74 [64; 97] mm Hg). The control group consisted of 20 healthy volunteers without HTN (mean age - 33 ± 6 yrs, 100% were male, mean BMI 26 ± 4 kg/m2, office SBP/DBP 126 [124; 128] / 70 [65; 75] mm Hg).
The thickness and area of the epicardial fat were measured by CT-scan images with parasternal short axis view at basal, mid-ventricular and apical levels and horizontal long axis view directly surrounding the main coronary arteries

Results:
EAT thickness was higher in AH group comparing to healthy volunteers (7,42 [5,22; 11,01] vs 7,17 [4,67; 9,67] mm, p < 0.05) and EAT square was larger in study group comparing to control group (93,5 [60,3; 267.0] vs 88,7 [50,7; 126,6] mm2, p < 0.05). Correlations between EAT square and LDL-cholesterol (r = 0.53, p < 0,05), HDL-cholesterol (r = -0,51, p < 0,05), interventricular septum thickness of the left ventricle (r = 0.47, p < 0,05), left ventricular posterior wall thickness (r = 0.56, p < 0,05), relative wall thickness (r = 0.45, p < 0,05) were found in AH group. No significant correlations were found in the control group.

Conclusions:
The accumulation of EAT among patients with AH is larger than among people with normal blood pressure. Epicardial adipose tissue thickness as early marker of visceral obesity associated with left ventricular emodelling in young non-obese patients with essential hypertension.
LONG-TERM RESULTS FROM THE SPYRAL HTN-ON MED TRIAL: RENAL DENERVATION INCREASES TIME IN BLOOD PRESSURE TARGET RANGE OVER 36 MONTHS
Authors: Tsioufis Konstantinos , Kandzari David , Kario Kazuomi , Townsend Raymond , Mahfoud Felix , Weber Michael , Schmieder Roland , Pocock Stuart , Fahy Martin , Bohm Michael 
Published: June 2022

Objective:
Six-month results from the SPYRAL HTN-ON MED pilot trial showed that patients with antihypertensive medications that underwent renal denervation (RDN) had a significantly greater reduction in 24-hr ambulatory and office systolic blood pressure (BP) from baseline compared to sham control. However, the effect of RDN on BP burden over time has not been established. Time in target range (TTR) analysis estimates the percent of time since procedure spent in a preferred systolic BP range as an indicator of BP control. An increase in TTR is associated with significantly lower risk of major cardiovascular events. In this analysis, we evaluate the long-term safety and efficacy of RDN in the SPYRAL HTN-ON MED pilot trial.

Design and method:
Eligible patients were enrolled in SPYRAL HTN-ON MED with an office systolic BP (OSBP) of 150 to < 180 mmHg, office diastolic BP > = 90 mm Hg, and a 24-hr mean ambulatory systolic BP (ASBP) of 140 to < 170 mmHg. Successive follow-up BP measures over 36 months were linearly interpolated to estimate TTR over time. BP target range was defined as 24-hr ASBP < = 140 mmHg and OSBP < = 140 mmHg. TTR was calculated for each patient as the proportion of time spent in the target BP range since the procedure, including the baseline BP measurement. At 24 months (RDN, n = 34; control, n = 17) there were fewer patients with follow-up measures in the control group due to protocol requirements and the option for patients to crossover. For sham control patients who later crossed over to RDN before their 36-month follow-up (n = 13), the last measure prior to RDN was imputed at 36 months.

Results:
Long-term, 36-month safety and efficacy outcomes of the first 80 patients andomised 1:1 into the RDN (n = 38) and sham control arms (n = 42) will be presented at ESH 2022, in addition to a time in blood pressure target range analysis.

Conclusions:
Thirty-six month results evaluating the long-term efficacy and durability of RDN compared to a sham control in SPYRAL HTN-ON MED for patients with uncontrolled hypertension will be presented at ESH 2022.
GENERALISED MICROVASCULAR DYSFUNCTION IS NONLINEARLY ASSOCIATED WITH HIGHER EXERCISE BLOOD PRESSURE – THE MAASTRICHT STUDY
Authors: Zhou Tan Lai , Kroon Abraham , Houben Alfonsius , Jansen Jacobus , Berendschot Tos , Webers Caroll , Van der Kallen Carla , Schram Miranda , Stehouwer Coen 
Published: June 2022

Objective:
Exercise blood pressure (BP), both high and low responses, is associated with the development of cardiovascular disease and all-cause mortality. However, it is unclear whether microvascular dysfunction is a determinant of exercise BP. Therefore, we investigated whether microvascular dysfunction was (nonlinearly) associated with exercise BP.

Design and method:
In the population-based Maastricht Study (n = 1,688; age 59 ± 8 years; 51% men), generalised microvascular dysfunction was constructed by a composite score of features of cerebral small vessel disease, retinal microvascular features, albuminuria, heat-induced skin hyperaemia and plasma biomarkers of microvascular dysfunction. Similarly, we constructed a composite score of exercise systolic BP and diastolic BP by combining BP at moderate workload, at peak exercise, change per minute and at 4 minutes after recovery. We used linear regression with adjustments for age, sex, lifestyle and cardiovascular risk factors, including resting BP. Nonlinearity was investigated by adding a quadratic term of generalised microvascular dysfunction

Results:
After adjustments, generalised microvascular dysfunction was nonlinearly associated with both the composite score of exercise SBP and DBP in an inverted U-shape fashion (p-nonlinear for exercise SBP < .001; for exercise DBP .001). When we divided microvascular dysfunction into quintiles, exercise SBP and DBP did not become higher after the middle quintile, and plateaued or were lower in the highest quintiles of microvascular dysfunction.

Conclusions:
Generalised microvascular dysfunction is nonlinearly associated with higher exercise SBP and DBP in an inverted U-shape fashion. These findings support the hypothesis that generalised microvascular dysfunction is a determinant of both high and low exercise BP responses.
EXPOSURES TO INTIMATE PARTNER VIOLENCE AND NON-PARTNER SEXUAL VIOLENCE ARE ASSOCIATED WITH HYPERTENSION IN SOUTH AFRICAN WOMEN
Authors: Nguyen Kim , Abrahams Naeemah , Jewkes Rachel , Mhlongo Shibe , Seedat Soraya , Meyers Bronwyn , Lombard Carl , Garcia-Moreno Claudia , Chirwa Esnat , Kengne Andre , Peer Nasheeta 
Published: June 2022

Objective:
South African women suffer from a dual burden of gender-based violence and hypertension. Studies suggest abuse exposures may increase the risk of hypertension by contributing to psychological stress, but this association has not been clearly described. This study described the associations of intimate partner violence (IPV), non-partner sexual violence (NPSV) and sexual harassment (SH) exposures with hypertension, and potential mediators of those associations in South African women aged 18 to 40 years.

Design and method:
Baseline data from the Rape Impact Cohort Evaluation study, including history of sexual, physical, emotional and economic IPV, NPSV and SH were examined using validated questionnaires. Hypertension was based on measured blood pressure (equal or higher than 140/90 mmHg) or a previous diagnosis. Logistic regression models examining the associations between various types of IPV, NPSV and hypertension adjusted for traditional hypertension risk factors and other traumatic exposures including recent rape incident. Mediation effects of body mass index, HIV infection, current smoking, alcohol binge drinking, depressive symptom scores and post-traumatic stress symptom (PTSS) scores on the associations using multiple mediation models adjusted for age and recent rape exposure.

Results:
Among 1742 women, 218 (12.5%) had hypertension. Hypertension prevalence was higher in women with, compared to without, a history of all four types of IPV (15% vs. 9%), sexual (19% vs. 11%), physical (16% vs. 9%), emotional (17% vs. 9%) and economic IPV (19% vs. 11%); NPSV (18% vs. 11%) and SH (29% vs. 11%), (p-values were equal or above 0.001). More than one episode of NPSV (adjusted odds ratio (aOR): 1.63; 95%CI: 1.27–2.67), any SH (aOR: 2.56; 95%CI: 1.60–4.03), frequent physical (aOR: 1.44; 95%CI: 1.06–1.95) and emotional IPV (aOR: 1.45; 95%CI: 1.06–1.98), and greater severity score of emotional IPV (aOR: 1.05; 95%CI: 1.02–1.08) were associated with hypertension. Current depression, PTSS and/or alcohol binge drinking completely or partially mediated these associations.

Conclusions:
The modifiable associations of IPV, NPSV and SH with hypertension highlight that, while gender-based violence must be prevented, public health interventions should incorporate monitoring blood pressure of violence victims, determining a history of violence in hypertension patients, and providing counselling.
MRI IN THE ASSESSMENT OF CEREBRAL INJURY AND CEREBROPROTECTIVE EFFECTS OF RENAL DENERVATION IN RESISTANT ARTERIAL HYPERTENSION
Authors: Sukhareva Anna , Falkovskaya Alla , Baev Andrey E. , Mochula Olga V. , Maksimova Alexandra S. , Ryumshina Nadezhda I. , Shelkovnikova Tatyana A. , Zyubanova Irina V. , Tsoi Ekaterina I. , Manukyan Musheg A. , Mordovin Viktor F. , Ussov Vladimir Yu 
Published: June 2022

Objective:
The purpose of this single-centre, prospective, comparative study was to evaluate the pattern and severity of the brain structural changes in patients with resistant hypertension (RH) based on MRI assessments and their changes one year after renal denervation (RDN).

Design and method:
The study comprised 58 patients with RH, aged 52.1 ± 9.1 years, who underwent RDN. Patients underwent office blood pressure measurements, 24-hour blood pressure monitoring, and brain MRI scanning. Using brain MRI, the cerebrospinal fluid (CSF) system measurements, the presence of periventricular leukoaraiosis and focal changes in the brain white matter were evaluated.

Results:
Initially, patients with RH had a high incidence of the structural brain alterations: 75% with fine focal brain lesions, 75% with impaired CSF dynamics, 23% with sulcal widening, and 90% with periventricular oedema. After RDN, a significant hypotensive effect was noted. According to brain MRI, the number of patients without impaired CSF dynamics did not change significantly: 25% initially, and 20% a year later (χ
2 = 0.63 p = 0.43, and χ2 = 0.72 p = 0.40). The number of patients with grade I impaired CSF dynamics after 6 months significantly increased after 12 months from 50% to 64% (χ2 = 4.00, p = 0.046) due to lowering the number of patients without impaired CSF dynamics and patients with grade II impaired CSF dynamics (χ2 = 1.56, p = 0.21). The number of patients with sulcal widening significantly decreased: from 23% to 8% one year following RDN (χ2 = 40.21 p = 0.000). The incidence of periventricular cerebral oedema did not significantly change one year after the procedure; however, the incidence of fine focal brain lesions significantly decreased (from 75 to 60%, p = 0.02).

Conclusions:
Thus, it has been revealed that patients with RH are characterised by a high incidence of structural brain alterations based on MRI assessments. A year after bilateral renal denervation, there are significant improvement in intracranial hypertension signs and decrease in the incidence of fine focal brain lesions, without a significant change in the CSF dynamics parameters (Table 1). Figure 1 shows a clinical example of a decrease in the number of fine focal brain lesions after the intervention.
RELATIONSHIP BETWEEN COGNITIVE IMPAIRMENT AND HYPERTENSION MEDIATED ORGAN DAMAGE: THE VOBARNO STUDY
Authors: Arnoldi Chiara , Capellini Sara , Zuccotti Luca , Paini Anna , Salvetti Massimo , Rozzini Luca , Aggiusti Carlo , Bertacchini Fabio , Stassaldi Deborah , Padovani Alessandro , Muiesan Maria Lorenza 
Published: June 2022

Objective:
Background Several studies have suggested the presence of a relationship between hypertension in mid-life and the subsequent development of mild cognitive impairment (MCI) and dementia.
Aim: to analyze the relationship between baseline blood pressure (BP), cardiovascular risk factors and presence of Hypertension Mediated Organ Damage (HMOD) and cognitive performances oppler after a follow-up period of 12 years in 149 subjects participating into the Vobarno Study.

Design and method:
149 subjects (52% female, mean age 54.9 ± 8, 9 ± 3.25 school years, 59% hypertensives) underwent blood chemistry, arterial pressure measurement, echocardiography, carotid oppler ultrasound and measurement of central arterial pressure (PWA) and carotid-femoral pulse wave velocity (PWV). All subjects underwent a neuropsychological evaluation with standardized tests performed at a follow-up visit 12 years later.

Results:
57 subjects with MCI at follow-up had baseline higher arterial pressure values (SBP and PP clinical and 24 h p < 0.05), IMT (1.23 ± 0.34 vs 1.12 ± 0.25 p < 0.05), and PWV (11.45 ± 3.37 m/sec vs 10.49 ± 1.74 p < 0.05) than those observed in the 92 subjects without MCI. Subjects with MCI were divided in two groups according to presence of amnesia (18 and 21% of total, respectively). Baseline IMT was significantly higher in subjects who developed non-amnesic MCI when compared with patients without MCI (Meanmax 1.30 ± 0.36 mm vs 1.12 ± 0.25 mm p < 0.05; CBmax 1.30 ± 0.29 mm vs 1.16 ± 0.24 mm p < 0.05); no differences were found between amnesic and nonamnesic subjects.

Conclusions:
our results show that baseline presence of hypertension and HMOD may be associated with cognitive performance detected after a mean period of 10 years. Aortic stiffness (measured as PWV) appears to be a less sensitive predictor of cognitive decline than increased IMT.
CURRENT PRACTICES OF BP MEASUREMENT IN CHILDREN AND ADOLESCENTS ACROSS EUROPEAN COUNTRIES: A SURVEY BY THE HYPERCHILDNET COST ACTION WG ON DEVICES
Authors: Stampouli Styliani , Floriano Fabiana , López-Valcárcel Beatriz , Wuhl Elke , Lurbe Empar 
Published: June 2022

Objective:
Objective: The main objective was to carry out a survey on current practices of BP measurement used among health care providers involved in the care of children and adolescents.

Design and method:
Design and methods: A 22 questions survey was released online from September 2, 2021 to September 27, 2021. The survey's link was sent to primary care physicians and pediatricians from the 22 European COST country members and it was also posted on the HyperChildNET website.

Results:
Results: The survey was assessed by 476 individuals and fully completed by 293. It was answered by general practioneers and pediatricians as well as pediatric nephrologists, pediatric cardiologists and pediatric endocrinologists, half of them working in primary care and the other half in hospital settings. Office BP measurement was used for clinical decision-making by 49% of the survey respondents while 29.7% used ABPM (Ambulatory BP Monitoring) and 16% home BP measurements. Only 11% routinely screen for high BP in normotensive children (Figure). Auscultatory and oscillometric devices were used in 57% and 41% of the settings, respectively. The main reason for selecting a BP device was availability in the institution in 60%, ease to use in 25.5% and validation in the relevant age group in 11.5%. Cuff size was selected according to individual child or adolescent mid arm circumference by 55% of the responders. A usual pitfall was combining cuffs from different devices and manufactures reported by 47.7% of the responders. Moreover, 42% performed only one BP measurement at each office BP visit. There was heterogeneity on the reference values used to evaluate the BP status with 27.4% using country specific BP reference tables and the rest different guidelines’ staging schemes. Eighty-three % used published reference values and 15.4% internet-based application for BP staging in children and adolescents.

Conclusions:
Conclusions: Variation in practices among health care providers show the emerging need of defining criteria to benchmark the different BP measurement devices, as well as to promote awareness for the evaluation of hypertensive children across Europe.
LIPID INDICES, ARTERIAL DAMAGE AND ALBUMINURIA IN PEDIATRIC PATIENTS WITH UNTREATED PRIMARY HYPERTENSION
Authors: Skrzypczyk Piotr , Pawlik Katarzyna , Bujanowicz Adam , Wroniewicz Tobiasz , Szyszka Michal , Ofiara Anna , Panczyk-Tomaszewska Malgorzata 
Published: June 2022

Objective:
Adult data proved that dyslipidemia is associated with cardiovascular risk. Our study aimed to analyze the relation between lipid indices, arterial damage and urinary albumin excretion (UAE) in children with primary hypertension (PH).

Design and method:
In 87 pediatric patients (15.10 ± 2.68 years, 60 boys, 27 girls) with untreated PH, we nalysed total, high-density, and low-density lipoprotein cholesterol (T-C, LDL-C, HDL-C), triglycerides (TG), and lipid indices: TG/HDL-C, Non-HDL-C, T-C/HDL-C, LDL-C/HDL-C, atherogenic index of plasma (AIP), atherogenic index (AI), lipoprotein combine index (LCI), and CHOLIndex (LDL-C - HDL-C). Additionally, we assessed 24 h ABPM, central and peripheral office BP, and arterial damage: aortic PWV, AIx75HR, cIMT, carotid arterial stiffness estimated by ultrasonic wall tracking (E-tracking - ET) and UAE [mg/24 h]. Lipid reference values were taken from the American Academy of Paediatrics 2011 Guidelines.

Results:
In the study group, borderline/high T-C was found in 22 (25.3%), LDL-C in 10 (11.5%), TG in 45 (51.7%), and borderline/low HDL-C in 28 (32.2%) patients; overall, 60 (69.0%) patients had dyslipidemia. Children with borderline/high LDL-C had significantly higher aPWV (5.83 ± 1.78 vs. 5.26 ± 0.78 [m/s], p = 0.047) and UAE (16 [8–122] vs. 8 [5–22] [mg/24], p = 0.034) compared to patients with normal LDL-C. In 87 studied children, UAE correlated with T-C and LDL-C (R = 0.269, p = 0.017; R = 0.245, p = 0.030) and AIx75HR with T-C (R = 0.228, p = 0.035). Also, ET augmentation index (ET AIx) correlated with HDL-C, T-C/HDL-C and AI (R = -0.245, p = 0.023; R = 0.233, p = 0.031; R = 0.233, p = 0.031), and maximal diameter of common carotid artery (D_max) with HDL-C, TG/HDL-C, T-C/HDL-C, LDL-C/HDL-C, AIP, and AI (R = -0.332, p = 0.002; R = 0.220, p = 0.042; R = 0.255, p = 0.018; R = 0.223, p = 0.039; R = 0.220, p = 0.042; R = 0.255; p = 0.018). Logistic regression revealed that the rise in CHOLIndex increased risk of elevated (>30 mg/24 h) UAE (OR: 1.035 95CI: 1.008–1.070).

Conclusions:
1. Lipid disturbances are common in pediatric patients with PH
2. Elevated lipid indices are associated with common carotid artery diameter and stiffness in hypertensive children and adolescents.
3. Pediatric patients with PH and abnormal LDL cholesterol are at risk of increased aortic stiffness.
4. CHOLIndex may serve as a marker of risk of hypertensive nephropathy in pediatric patients with PH.
CIRCADIAN BLOOD PRESSURE PROFILE IN PEDIATRIC PATIENTS WITH PRIMARY HYPERTENSION
Authors: Skrzypczyk Piotr , Ofiara Anna , Szyszka Michal , Wabik Anna , Pietrzak Radoslaw , Werner Bozena , Panczyk-Tomaszewska Malgorzata 
Published: June 2022

Objective:
Disturbed circadian blood pressure (BP) profile is a risk factor for cardiovascular complications in adults. The study aimed to evaluate factors affecting circadian BP profile and its association with hypertension-mediated organ damage (HMOD) in pediatric patients with primary hypertension (PH).

Design and method:
The study included 112 children (79 boys, 33 girls, 14.7 ± 2.7 years) with untreated PH. Circadian BP profile was assessed by 24-hour ABPM. Disturbed circadian BP profile (non-dipping) was defined as a nocturnal drop in systolic or diastolic BP (SBP, DBP) < 10%. A nocturnal drop in SBP or DBP > 20% was defined as extreme dipping. Patients were evaluated for central BP, HMOD (left ventricular mass index - LVMI, aortic pulse wave velocity, augmentation index (AIx75HR), intima-media thickness, albuminuria), and clinical and biochemical parameters, including sodium-potassium balance.

Results:
In the study group, the mean nocturnal drop in SBP was 10.9 ± 5.9 [%] and in DBP - 16.2 ± 8.5 [%]. Non-dipping was found in 50 (44.6%) children and extreme-dipping in 29 (25.9%) patients. The nocturnal drop in SBP correlated negatively with Z-scores of body weight (r = -0.191, p = 0.043) and BMI (r = -0.242, p = 0.010) and with LVMI [g/m2.7] (r = -0.395, p = 0.006). The nocturnal drop in SBP and DBP correlated positively with urinary potassium excretion [mmol/kg/24 h] (r = 0.656, p = 0.001 and r = 0.540, p = 0.011, respectively). Patients with disturbed circadian blood pressure profile were characterized by higher LVMI (44.5 ± 12.5 vs. 36.8 ± 8.8 [g/m2.7]) and albuminuria (median: 10.8, IQR: 5.3–53.3 vs. median: 8.1, IQR: 5.5–16.4 [mg/24 h], p = 0.043) and lower urinary potassium excretion (0.6 ± 0.2 vs. 1.1 ± 0.3 [mmol/kg/24 h]). Extreme-dipping patients had a higher AIx75HR than the other patients (median: + 3.3, IQR: -6.3- + 17.7 vs. -4.6, IQR: -17.3- + 4.0 [%], p = 0.048).

Conclusions:
1. Disturbed circadian BP profile is common in children with PH and should not be considered a marker of secondary hypertension.
2. Disturbed circadian BP profile may be associated with higher body weight and lower dietary potassium intake.
3. Pediatric patients with PH and disturbed BP profile are at risk for HMOD: left ventricular hypertrophy and microalbuminuria.
4. Extreme-dipping may be associated with increased arterial stiffness in children with PH.