bluuebunny/crossref_metadata_2025_split huggingface dataset:
FACTORS ASSOCIATED TO POOR ADHERENCE TO TREATMENT IN THE TUNISIAN ELDERLY
Authors: Mzoughi Khadija , Bergaoui Zeineb , Soltani Chayma , Belkahla Noufeil , Bouzidi Hela , Zairi Ihsen , Kamoun Sofien , Labbene Sonia , Mrad Imtinene Ben , Kraiem Sondos 
Published: June 2022

Objective:
Management of hypertension requires a good adherence to treatment for a successful antihypertensive long-term therapy.

Purpose:
The aim of our study was to identify the factors associated with poor adherence to treatment in the 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. Adherence to treatment was evaluated using EvalOBs, a visual scale of adherence to antihypertensive treatment.

Results:
Median age was 73 and sex ratio 0.57. Our patients were completely dependent in 4% of cases and among those aged 80 and over, 68.2% were frail. Adherence to treatment was satisfactory in 75.2% of cases. Patients forgot to take their antihypertensive treatment the day of the consultation in 51% of cases and 33% had a medication breakdown since the last consultation. Seventeen per cent of the patients have been away from their treatment because of memory disorder and 7%missed their treatment because some days they feel that the treatment is doing more harm than good.
In multivariate analysis, the factors associated with poor adherence to treatment were: male (OR = 11,774; p = 0.013), patient smoker (OR = 0,167; p = 0,02), medication break-down (OR = 0253; p = 0,006) and forgetting the treatment the day of the consultation (OR = 0,159; p = 0,047).

Conclusions:
Detection of the risk of non-adherence and therapeutic education are necessary to improve the adherence to antihypertensive treatment. The education must be focused on male and smokers and a better medication supply is needed.
ACHIEVED BLOOD PRESSURE LEVELS, COMORBIDITIES AND ONE YEAR PROGNOSIS OF ANTICOAGULATED PATIENTS WITH ATRIAL FIBRILLATION
Authors: Postadzhiyan Arman , Velichkova Anna , Markova Simona , Tochev Sotir , Andreeva Lora , Raev Dimitar 
Published: June 2022

Objective:
The aim of the study was to analyze clinical characteristics of the consecutive sample of patients with atrial fibrillation admitted to Saint Anna University Hospital, ESH Excellence center of hypertension.

Design and method:
Consecutive sample of 215 patients with AFib (112 M, 103 F; age 70.5) was enrolled 2017–2019. Data were collected during hospitalization and the patients were followed for one year for the occurrence of death/ischemic events and bleeding. BP was measured in a sitting position using an automatic validated device. In the present analysis we report the associations of mean achieved BP during the year (an average 6,8 BP measurements) with the key ischemic outcomes.

Results:
Mean CHADSVASC was 3,77 ± 1.8 and HASBLEED 2,91 ± 1,3 with 191 (88.8%) and 127 (59.1%) of patients having CHADSVASC= > 2 and HASBLEED= > 3. Arterial hypertension was the most frequent risk factor in 88.4% (average duration of 17.7 ± 9 years). Previous history of myocardial infarction or stroke, obesity, heart failure and chronic kidney disease were established in 27,9%, 23.3%, 52.6%, 79,5% and 55.8%. OAC therapy was changed in approximately 23% during the year. Average BP values were 136/84.7 mmHg at admission and mean achieved BP during the follow-up were 129.7/81.9 mmHg. The annual event rates for death/ischemic events were 19.1%, for cardiovascular death 7% and for all cause bleeding 20%. Factors, associated with subsequent ischemic events includes higher CHADSVASC (4.2 vs 3.6) and HASBLEED (3.6 vs 2.7), presence of CKD (eGFR Epi < 60 ml/min) and worsening of CKD during the year (-6.7 ml/min vs – 1 ml/min). On treatment SBP> 130 mmHg and < 110 mmHg was associated with death/ischemic events compared with SBP 120–130 mmHg, HR 2.42 (0.9–5.4) and 2.76 (1–7.6) respectively. Similar patterns were observed for DBP with an increased risk at < 70 mmHg HR 1,52 (0.9–2.56) and > 90 mmHg HR 2,31 (1,1–8.1). Factors associated with unfavorable outcomes at low achieved BP < 120/80 were the presence of ischemic heart disease, CKD or heart failure.

Conclusions:
The presence of comorbidities mediate the effect of blood pressure on prognosis for ischemic complications especially at low achieved levels of BP.
ATRIAL FIBRILLATION INCIDENCE IN SARS-COV-2 INFECTED PATIENTS: PREDICTORS AND RELATIONSHIP WITH IN-HOSPITAL MORTALITY
Authors: Maloberti Alessandro , Giannattasio Cristina , Rebora Paola , Occhino Giuseppe , Ughi Nicola , Rizzo Jacopo , Fabbri Saverio , Leidi Filippo , Cartella Iside , Algeri Michela , Scarpellini Sara , Rossetti Claudio , Epis Oscar , Molon Giulio , Bonfanti Paolo , Valsecchi Maria Grazia , Genovesi Simonetta 
Published: June 2022

Objective:
Among the different CardioVascular (CV) manifestation of the COronaVIrus-related Disease (COVID) particular attention has been paid to arrhythmia and particularly to Atrial fibrillation (AF). The aim of our study was to assess the incidence of AF episodes in patients ospitalisat for COVID and to evaluate its predictors and its relationship with in-hospital all-cause mortality.

Design and method:
We enrolled 3435 cases of SARS-CoV2 infection admitted in four hospitals in Northern Italy. We collected data on clinical history, vital signs, Intensive Care Unit (ICU) admission, laboratory tests and pharmacological treatment. AF incident and all-cause in-hospital mortality were considered as outcomes.

Results:
145 (4.2%) patients develop AF during ospitalisation, with a median time of 3 days (IQR: 0, 11.5) from admission. Incident AF patients were older and had lower eGFR, lower platelet and lymphocytes count and higher C-Reactive Protein (CRP), were admitted more frequently to ICU and more frequently died compared to subjects that didn’t present AF. At the Cox regression model significant determinants of incident AF were older age (HR 1.070; 95% CI: 1.048, 1.092), history of AF (HR 2.800; 95% CI: 1.465, 5.351), ischemic heart disease (HR 0.324; 95% CI: 0.130, 0.811) and ICU admission (HR 8.030; 95% CI: 4.511, 14.292). Incident AF was a predictor of all-cause mortality (HR 1.679; 95% CI: 1.170, 2.410), together with age (HR 1.053; 95% CI: 1.042, 1.065), dementia (HR 1.553; 95% CI 1.151, 2.095), platelet count (HR 0.997; 95% CI: 0.996, 0.999) higher CRP (HR 1.004; 95% CI: 1.003, 1.005) and eGFR (HR: 0.991; 95% CI: 0.986, 0.996)

Conclusions:
AF present as the main arrhythmia in COVID-19 patients and its development during the ospitalisation strongly relates with in-hospital mortality.
A PROSPECTIVE STUDY ON THE ASSOCIATION BETWEEN ATRIAL FIBRILLATION AND BLOOD PRESSURE IN AN ELDERLY CHINESE POPULATION
Authors: Chen Yi , Zhang Wei , Sheng Chang-Sheng , Huang Qi-Fang , Cheng Yi-Bang , Guo Qian-Hui , Zhang Dong-Yan , Li Yan , Freedman Ben , Wang Ji-Guang 
Published: June 2022

Objective:
In the present prospective study, we investigated the association between atrial fibrillation (AF) and blood pressure (BP) in an elderly Chinese population.

Design and method:
Elderly (aged 65 years and over) residents were recruited from 6 communities in Shanghai from 2006 to 2020. 9019 participants who did not have AF at baseline had at least one ECG recording during follow-up. BP status at baseline was defined according to the European hypertension guidelines as optimal, normal, or high-normal BP, and stage 1, 2 or 3 hypertension.

Results:
During a median of 3.5 years follow-up, the overall incidence rate of AF was 5.6 per 1000 person-years (n = 178, men vs. women: 7.0 vs. 4.5 per 1000 person-years, P = 0.008). The AF incidence increased with both higher systolic and diastolic BP. Statistical significance was achieved for age- and sex-adjusted hazard ratio (HR) relative to optimal BP in stage 2 or 3 systolic hypertension (1.78, 95% confidence interval [CI] 1.04–3.05, P = 0.03) and in stage 1 (1.67, 95% CI 1.01–2.77, P = 0.04) and stage 2 or 3 systolic and diastolic hypertension (1.93, 95% CI 1.11–3.33, P = 0.02) and for fully adjusted HR relative to optimal BP in stage 2 or 3 systolic and diastolic hypertension (1.76, 95% CI 1.00–3.08, P = 0.05). The association between AF incidence and BP status tended to be stronger in participants with no than those with a history of cardiovascular disease at baseline (P for interaction = 0.06). Indeed, in participants with no history of cardiovascular disease at baseline, multivariate-adjusted HRs of AF relative to their counterparts with optimal BP were statistically significant in stage 1 (1.76, 95% CI 1.00–3.11 P = 0.05) and stage 2 or 3 systolic hypertension (2.08, 95% CI 1.12–3.85, P = 0.02) and stage 1 (1.93, 95% CI 1.06–3.50, P = 0.03) and stage 2 or 3 systolic and diastolic hypertension (2.34, 95% CI 1.24–4.44, P = 0.01).

Conclusions:
In the Chinese people aged 65 years and over, AF incidence is higher with high BP, especially systolic hypertension and in the absence of cardiovascular disease.
INFLUENCE OF MEAN OFFICE BLOOD PRESSURE(BP) LEVELS ON MORTALITY IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION (HFPEF)
Authors: Chen Jiwei , Sánchez Marcos , Viñas Esther , Costafreda Miriam , Torres Manuel , Martínez Rosa , Benítez Cristina , Sierra Cristina , Coca Antonio , Camafort Miguel 
Published: June 2022

Objective:
Heart failure (HF) is a major public health problem and one of the leading causes of ospitalisations and death. HFpEF is related to hypertension (HT) either in the pathogenesis and outcome, particularly in the elderly, and is becoming an increasingly worrisome health issue due to higher life expectancies in Western Countries. This study aimed to evaluate the influence of BP and its control in elderly patients with HFpEF.

Design and method:
Retrospective study in outpatients older than 80 years with stable HFpEF, seen in a University Hospital. Data were obtained from electronic medical records with prior authorization from the Ethics Committee. For the analysis, the first measured Office BP levels were used.

Results:
106 patients were included. For Systolic BP (SBP) analysis, we use three cut-off points of SBP (measured in the office at the first visit): <░90░mmHg, between 90–139░mmHg and >░140░mm Hg. For Diastolic BP (DBP) we used two cut-off points: <░70 and >░70░mm Hg. As for the characteristics, the only differences were that those with Low SBP had significantly lowered LVEF compared to those with normal or high SBP (54% vs 59 p 0.035). As for DBP, those with low DBP had significantly lowered heart rate than those with high DBP (72░bpm vs 79░bpm, p 0.039). There were no mortality differences between those with low SBP, normal SBP and high SBP fx8, neither among patients with low DBP nor normal/high DBP. Kaplan Meier curve showed a non-significant trend to higher mortality on those with lower values of BP

Conclusions:
In our study, we did not observe differences in mortality between patients with low normal or high SBP, neither on those with high, normal nor low DBP. Although there may be a selection bias and this is a retrospective study, more studies are needed to assess the influence of BP control on the evolution of HFpEF in octogenarian patients with stable disease.
COMPARATIVE EFFICACY OF ANTIARRHYTHMIC MEDICATIONS FOR SINUS RHYTHM MAINTENANCE AFTER ELECTRICAL CARDIOVERSION FOR ATRIAL FIBRILLATION
Authors: Sokolova Emma , Rudzitis Ainars , Kalejs Oskars 
Published: June 2022

Objective:
Sinusa rhythm maintenance while using IC class medications is not practically studied. IC class medications aethacizinum is widely used, but has no large studies proving safety and efficacy.
The aim of this study was to compare the efficacy of class IC antiarrhythmic medications, for sinus rhythm maintenance, after ECV (electrical cardioversion), in patients with atrial fibrillation (AF).

Design and method:
It is an open-label, one-center prospective study that held in the Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital from September 2019 to June 2020. Before hospitalisation patients have not received any antiarrhythmic drugs except of amiodarone and beta blockers. Patients with persistent form of AF received beta blockers (bisoprolol 5 mg daily), amiodarone (200 mg daily), propaphenone (300 mg daily) or aethacizinum (100 mg daily) for 6 months after conversion to sinus rhytm by ECV. Rest ECG, Holter monitoring, echocardiography, ergometer stress test, blood tests were performed.

Results:
The total number of patients finished study per protocol – n = 52. On echocardiographical study no significant changes in AFR (AF paroxysm group) and MSR (maintained sinus rhythm) groups were found. No safety parameters were significantly changed in this group. All patients were followed up for 6-month period. Reccurance rate of AF in aethacizinum group showed a statistically significant superiority compared to propafenone (55,6% vs 72,5%) (p = 0,05). Patients with higher atrial strain and strain rate appear to have a greater likelihood of staying in sinus rhythm. In our research, duration of AF was not predictive value of maintenance of SR at follow-up after 6 months from ECV.

Conclusions:
Antiarrhythmic medications of Ic class may be safe in patients with persistent form of atrial fibrillation and have no negative impact on inotropic function of myocardium. The most commonly used drug from Ic class ir etacizin. The observed efficacy provides the rationale for a larger, double-blind controlled study with different antiarrhythmic medications in different daily dosage.
COMBINING NATURAL LANGUAGE PROCESSING METHOD AND MENDELIAN RANDOMIZATION TO ESTABLISH CAUSAL EFFECT OF BLOOD PRESSURE ON OUTCOMES
Authors: Le Nhu Ngoc , Tran Quoc Bao Tran , Bhaskar Ravi , Du Toit Clea , Padmanabhan Sandosh 
Published: June 2022

Objective:
Mendelian rioritisedn (MR) uses genetic variants as instruments to estimate a causal effect of an exposure on an outcome. Specific conditions need to be satisfied to ensure the validity of the genetic variant as an instrumental variable (IV). Pleiotropy is one of the reasons for invalid IV and erroneous causal estimation. We applied natural language processing (NLP) on multidimensional GWAS datasets enriched with gene-expression information to select appropriate IVs for MR analysis. The selected set of IVs was then used in MR analysis to investigate the causal effect of blood pressure (BP) on cardiovascular outcomes (ischaemic stroke, atrial fibrillation (AF), coronary artery disease (CAD), and chronic kidney disease (CKD)).

Design and method:
We curated corpus of data by integrating GWAS results, gene expression, single nucleotide polymorphism (SNP) proxies and proximate genes on 2955 phenotypes. We used chromosome cytobands to partition the genome into documents, in which SNPs, genes, tissues and phenotype domains are treated as the terms. We subsequently calculated term frequency – inverse document frequency (TF-IDF) for all the terms in the corpus and identified the cytobands with the highest TF-IDF for BP. Independent non-pleiotropic SNPs associated with BP in the rioritised cytogenetic bands were selected as IVs for two-sample MR analysis. We performed inverse-variance weighted (IVW) MR and MR Egger analysis using GWAS meta-analysis systolic BP (SBP) estimates and the following outcomes: ischaemic stroke (N = 440328), AF (N = 1030836), CAD (N = 547261), CKD (N = 117165). Analyses were performed on the MR-Base platform.

Results:
We identified 10 non-pleiotropic, BP-associated SNPs from the top 10 cytobands with the highest TF-IDF scores for BP over the whole genome. Two-sample MR analyses showed a significant causal relationship between genetically determined greater SBP and higher risk of ischemic stroke, AF but not for CAD and CKD (ischemic stroke: IVW = 0.03 ± 0.01, P = 0.006; MR-Egger = 0.05 ± 0.02, P = 0.09; AF: IVW = 0.03 ± 0.006, P = 9.017E-07; MR-Egger = 0.04 ± 0.01, P = 0.01) (Figure).

Conclusions:
Our joint NLP and MR analyses allowed selection of a parsimonious set of instrumental variable SNPs for MR analyses and may be an option for high-throughput analyses across multiple traits.
THE ROLE OF BIOCHEMICAL BIOMARKERS FOR NEURONAL ACTIVITY AND CLINICAL NEUROPSYCHOLOGICAL TESTS IN PATIENTS WITH CAROTID STENTING
Authors: Yaneva-Sirakova Teodora , Vassilev Dobrin , Karamfiloff Kiril , Hristova Julieta , Shumkova Monika , Dimov Anastas , Traykov Latchezar 
Published: June 2022

Objective:
The application of carotid stenting is rising. We need biomarkers, which would guide us and help in the assessment of its effectiveness regarding brain blood flow and cognition. Potential candidate biomarkers are the markers for neuronal activity Brain Derived Neurotrophic Factor (BDNF) and Neural Growth Factor (NGF). Their serum concentration is correlated with brain hemodynamics and function.

Design and method:
We included 78 patients: 39 with hemodynamically significant carotid stenoses and 39 controls - without. All underwent ultrasound diagnostics and ELISA test of BDNF and NGF serum concentrations. The biomarkers for neural activity in patients with significant carotid stenoses, were tested at 3 phases: before (n34), 24 h. post (n22) and at least 1 month after stenting (n18). Cognitive functions were assessed with MMSE and MoCA. On their basis the patients were classified as having or not potential mild cognitive impairment (MCI) Statistical analysis was done with SPSS 19(IBM), p < 0.05, CI 95%.

Results:
There was a significant difference in the BDNF concentration before and after carotid stenting (p < 0.0001); in BDNF [p = 0.001, CI (-5.11- -1.44)] and NGF [p = 0.049, CI (0.64–347.75)] between patients with significant stenoses/stenting and controls. Periprocedural hypotension, stroke history and MCI did not influence biomarkers concentrations. Correlation analysis showed intermediate positive correlation between systolic, diastolic, pulse pressure and biomarkers at a certain time of sampling. This association was proven for the systolic blood pressure by the regression analysis too. The mean values of BDNF after stenting raised and for NGF lowered after carotid stenting.

Conclusions:
A larger sample is needed to prove further our results, namely: 1. Arterial blood pressure is an important factor for BDNF and NGF concentrations; 2. The correlation between these markers and interventional treatment may be not linear; 3. There are significant differences in the serum concentrations of biomarkers for neural activity between patients with and without significant carotid stenoses.
Research Grant 2020 from Medical University Sofia, Bulgaria, contract 133/24.06.2020
CORRELATION OF CAROTID INTIMA-MEDIA THICKNESS AND PULSE WAVE VELOCITY WITH HEMATOCRIT, PLATELET COUNT AND FIBRINOGEN LEVELS IN DIPPER AND NON-DIPPER HYPERTENSIVE PATIENTS
Authors: Vazquez-Agra Néstor , Marques-Afonso Ana T. , Fernandez-Castro Ivan , Lopez-Paz Jose E. , Hermida-Ameijeiras Alvaro , Pose-Reino Antonio 
Published: June 2022

Objective:
Carotid intima-media thickness (IMT) and pulse wave velocity (PWV) are the two most widely recognized methods for the assessment of arterial stiffness. The aim of this study was to verify whether there is a correlation between them and some blood parameters in dipper and non-dipper hypertensive patients.

Design and method:
This was a cross-sectional study that included patients with arterial hypertension (AHT) who were greater than 18 years old. Demographic and epidemiological variables were collected. Blood pressure (BP) parameters were assessed by office BP measurements and 24-hour ambulatory BP monitoring (24 h ABPM). We collected blood samples for biochemistry, blood count and coagulation variables. Individuals were divided into two groups: dipper and non-dipper patients. Quantitative normally distributed variables were nalysed using the Student’s t-test while non-normally distributed variables were nalysed using the Mann–Whitney U-test. A Chi-square test was used for categorical variables to test differences between groups. This study was approved by the center Ethics Committee of Clinical Research, and it adhered to the ethical standards that were outlined in the Declaration of Helsinki. All subjects provided informed consent.

Results:
There were 563 patients (47% women) with a mean age of 54 years who were included in this study.
One third of patients suffered from diabetes and two out of three had plasma lipid abnormalities. There were differences in age, frequency of diabetes, dyslipidemia and antihypertensive therapy between dipper and non-dipper patients. After an adjustment for those variables, we observed a relevant correlation of PTC (Pearson correlation coefficient [r] -0.215, P = 0.002) and hematocrit (r 0.215 P = 0.002) with IMT in patients with a dipper profile while individuals with a non-dipper BP pattern showed a correlation of PWV with PTC (r -0.149, P = 0.031) and fibrinogen levels (r 0.238, P = 0.031). Uric acid levels were correlated with IMT in both groups of patients.

Conclusions:
It seems that some blood parameters could be linked to the development of arterial stiffness in both dipper and non-dipper patients. This was a preliminary retrospective, single-center study that could open the door to the investigation of new analytical indices in arterial stiffness.
IMPACT OF POLYCYSTIC OVARIAN SYNDROME (PCOS) ASSOCIATED WITH HYPERTENSION ON SOME METABOLIC MARKERS
Authors: Bendiab Nabila Taleb , Bouanane Samira , Ahmed Fatema Zohra Baba 
Published: June 2022

Objective:
Polycystic ovary syndrome (PCOS) is a multifactorial syndrome, including the hyper androgenism, ovulatory disorders with a polycystic appearance of the ovaries. PCOS is a disorder metabolic associated with an increased risk of insulin resistance, hyper insulinemia, central obesity, high blood pressure, type 2 diabetes, dyslipidemia and cardiovascular disease. Variability of sound expression and the difficulty of defining it with precision hamper the visibility of this affection, both in the population general than in a number of clinical situations. Several studies have highlighted an HTA in obese patients with PCOS.
The objective of our work consists in studying the impact of the HTA and PCOS association on the disturbances of the metabolism (hepatic, lipid and renal).

Design and method:
For this study, 26 hypertensive patients with this syndrome were selected, recruited from level of the Tlemcen teaching hospital, and 30 healthy women witnesses. After their consent, patients benefited a specific biochemical assessment of liver function (TGO transaminases, TGP), renal function (acid uric, creatinine, urea), and the lipid profile (total cholesterol, LDL, triglycerides).

Results:
A comparison of the results obtained in hypertensive and normotensive PCOS patients shown that there is a disturbance in hepatic metabolism, expressed by high levels of transaminases (TGO, TGP), kidney damage, due to increased creatinine and urea, with lipidogram disturbance in hypertensive women with PCOS compared to women witnesses.

Conclusions:
In conclusion, PCOS associated with hypertension is the source of many dysfunctions metabolic (dyslipidemia, kidney and liver damage). For this, the dietary management and drug treatment of this syndrome is a strategy to reduce complications associated metabolic.