bluuebunny/crossref_metadata_2025_split huggingface dataset:
ADHERENCE AND BLOOD PRESSURE CONTROL IN PATIENTS WITH PRIMARY ALDOSTERONISM
Authors: Widimsky Jiri , Nikrynova Thi Minh Phuong , Strauch Branislav , Petrak Ondrej , Kratka Zuzana , Holaj Robert , Kurcova Ivana , Maresova Vera , Waldauf Petr , Zelinka Tomas 
Published: June 2022

Objective:
To evaluate the adherence to MR antagonists and other antihypertensive therapy and blood pressure control in conservatively treated patients with primary aldosteronism.

Design and method:
We have consecutively investigated in an outpatient hypertension clinic conservatively treated subjects with previously confirmed primary aldosteronism (PA) (n- 50, 64,5 ± 9 years of age, 24% of women). The confirmation of PA was based on saline supression test in accordance with current guidelines. The PA patients were conservatively treated due to bilateral disease confirmed by adrenal venous sampling or refusal of the surgery. All subjects were regularly followed-up in our clinic. In addition to basic laboratory and clinical parameters, 24 hour ambulatory blood pressure monitoring (Spacelabs) was evaluated. Unplanned blood sampling for assesment of all serum antihypertensive drug concentrations by means of liquid chromatography-mass spectrometry was performed in all patients. The drug was considered positive when the concentration was at least at the lowest detectable level. Total noncompliance was defined as the absence of all measured antihypertensive drugs. Partial noncompliance was calculated as the absence of serum levels of at least one, but not all antihypertensive drugs apparently taken.

Results:
We have detected good blood pressure control (mean 24 h systolic/diastolic BP 130 ± 12/77 ± 9 mmHg). Average number of antihypertensive drugs was 3,9 ± 1,5. All subjects were treated by MR antagonists. 44% of patients received spironolactone (average daily dose 45 ± 20 mg) and in remaining 56% of subjects eplerenon was given (average daily dose 80 ± 30 mg) because of spironolactone side effects. Assesment of antihypertensive drug concentrations revealed full adherence in 80 %, partial nonadherence was noted in remaining 20 % of subjects. MR antagonists were detected in almost all subjects (49 out of 50).

Conclusions:
We have detected very good blood pressure control and adherence in conservatively treated patients with primary aldosteronism. Eplerenone had to be used due to spironolactone side effects quite often. Combination of MR antagonists with other antihypertensive drugs (mainly calcium channel blockers and thiazides) had to be used in majority of patients with PA.
RELATIONSHIP BETWEEN METABOLICALLY HEALTHY OBESITY AND THE DEVELOPMENT OF HYPERTENSION: A NATIONWIDE POPULATION-BASED STUDY
Authors: Yuan Yue , Sun Wei , Kong Xiangqing 
Published: June 2022

Objective:
Metabolically healthy obesity (MHO), which does not have a general definition, has been recognized as a transient phenotype with few cardiometabolic diseases. This study aimed to assess the relationship between the development of hypertension and metabolically healthy abdominal obesity (MHAO) and metabolically healthy general obesity (MHGO) phenotype.

Design and method:
This was a retrospective cohort study of 4764 adults who were enrolled from the China Health and Nutrition Survey (CHNS) study from 2009 to 2015. Obesity was classified as abdominal obesity based on waist circumference and as general obesity based on body mass index. Logistic regression was used to analyze the relationship between metabolic health combined with obesity and prehypertension and hypertension.

Results:
There were 412 (37.9%) participants with prehypertension and 446 (41.0%) participants with hypertension with the MHAO phenotype. Subjects with the MHAO phenotype had significantly higher risks of prehypertension [risk ratio (RR) = 1.89 (1.51–2.36), P < 0.001] and hypertension [RR = 2.58 (2.02–3.30), P < 0.001] than subjects with the metabolically healthy nonabdominal obesity (MHNAO) phenotype. A similar trend existed with regard to the subjects with the MHGO phenotype, particularly in young individuals aged under 64 years. Men with the MHAO phenotype seemed to have higher risks of prehypertension [men: 2.42 (1.52–3.86) vs. women: 1.76 (1.36–2.29)] and hypertension [men: 3.80 (2.38–6.06) vs. women: 2.22 (1.64–3.00)] than women when compared with those with the MHNAO phenotype.

Conclusions:
The MHO phenotype, regardless of the presence of general or abdominal obesity, showed a worse effect on the development of prehypertension and hypertension, particularly in young adults. Abdominal adiposity with healthy metabolic status is more strongly associated with incident hypertension in men than in women, guiding decision-making for sex-specific and risk-stratified obesity treatment.
POOR HYPERTENSION CONTROL AND DISAPPEARANCE OF MEDITERRANEAN LIFE STYLE ON THE CROATIAN ADRIATIC ISLANDS. HUNT ON THE SILENT KILLER (HSK) – OPPORTUNISTIC PUBLIC HEALTH ACTION
Authors: Tarnovski Lorka , Frkanec Stjepan , Katic Luka , Strbac Tea , Susnjara Petar , Lovakovic Josip , Kolaric Melanija , Stupin Ana , Josipovic Josipa , Baretic Maja , Boljesic Marta , Begic Zvonimir , Barisic Klara , Bilajac Lovorka , Radunovic Danilo , Prelevic Vladimir , Jelakovic Ana , Gellineo Lana , Domislovic Marija , Jelakovic Bojan 
Published: June 2022

Objective:
Mediterranean lifestyle is slowly disappearing along the Croatian coast and Croatian islands were supposed to be the last part of healthy living. Unfortunately, healthcare system is poorer on islands than in other parts of Croatia. Our aim was to analyse lifestyle and hypertension (HT) treatment and control among inhabitants of the Croatian islands.

Design and method:
HSK was organised by the Croatian Society of Hypertension and conducted by the WG- medical students in hypertension. A screening site was set up at the boat by which students traveled from island to island. Adult volunteers were recruited through opportunistic screening on five Adriatic islands. Trained medical students collected information through an extended questionnaire. HT was defined as blood pressure (BP) > 140/90mmHg (single occasion; an average of 2nd–3rd measurement; Omron M3) and/or self-reported use of drugs for HT. Results were compared with results from the general Croatian population (EHUH 2 cohort).

Results:
A total of 424 participants were included (196 men, average age 61 years). There were less obese and current smokers at islands than in the general Croatian population (26.5% vs. 33.1%; 21.5% vs. 25%, respectively, p < 0.05). Islanders were more physically active (> 1 time/week), eat more frequently fish (> 1 time/week), and use more frequently olive oil (daily basis) (44.1% vs. 26%, 79.9% vs. 32.5%, 72.6% vs. 14.9 %, respectively; p < 0.01). However, there were no differences in consumption of red meat, processed meat, cookies and cakes (p > 0.05). Less hypertensive patients were treated and control was achieved in less subjects on islands than in the general population (60.7% vs. 72.9%; 27.2% vs. 39.3%, respectively; p < 0.01).

Conclusions:
Some elements of Mediterranean life are still present on Croatian islands. However, several poor lifestyle habits are equally present on islands and in other Croatian regions. Treatment and control of HT are poorer on islands reflecting inadequate healthcare and lack of physicians. Public health authorities should reorganize health care on islands. In the meantime, such public health actions are warranted and must continue.
IMPACT OF PROTEINURIA ON LONG-TERM MORTALITY IN PATIENTS WITH HYPERTENSIVE CRISIS VISITING THE EMERGENCY DEPARTMENT
Authors: Shin Jeong-Hun , Kim Byung Sik , Kim Hyung-Jin , Yu Mi-Yeon 
Published: June 2022

Objective:
Hypertensive crisis is associated with poor clinical outcomes. Proteinuria, frequently observed in hypertensive crisis, is a risk factor for cardiovascular and all-cause mortality in patients with hypertension. However, in patients presenting with hypertensive crisis and proteinuria, the impact of proteinuria on long-term mortality are unknown. We investigated the association of proteinuria with all-cause mortality.

Design and method:
This retrospective study at a tertiary referral center conducted with adult patients who were admitted to the ED between 2016 and 2019 with hypertensive crisis, which was defined as systolic blood pressure > = 180 mmHg and/or diastolic blood pressure > = 100 mmHg. Of 10,219 patients with hypertensive crisis, 5,421 patients with an assay for proteinuria were enrolled in this study. Proteinuria was defined as a trace or more of protein on a urine dipstick test performed at ED.

Results:
Proteinuria was present in 2,855 (52.7%) of the 5,421 patients. At 3 years, crude all-cause mortality rates were 9.6% for patients who were negative proteinuria, 17.9% for those with trace proteinuria, 25.7% for those with proteinuria (1+), 28.9% for those with proteinuria (2+), 33.6% for those with proteinuria (> = 3+). After adjusting for sex, age, blood pressure, and comorbid condition, the hazard ratio (95% CI) for dipstick proteinuria was 1.74 (1.44–2.10) for those with trace proteinuria, 2.24 (1.84–2.72) for those with proteinuria (1+), 2.21 (1.76–2.78) for those with proteinuria (2+), 2.30 (1.75–3.01) for those with proteinuria (> = 3+) compared with the reference of negative proteinuria.

Conclusions:
Proteinuria, which was detected on a urine dipstick test, was a significant predictor of all-cause mortality in patients with hypertensive crisis.
LIPIDS’ METABOLISM AND ANGIOTENSINOGEN GENE (AGT, RS699) POLYMORPHISM ASSOCIATION IN PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION
Authors: Repchuk Yuliya , Sydorchuk Larysa 
Published: June 2022

Objective:
The study purpose was to analyze the association of angiotensinogen AGT (rs699) gene polymorphism with lipids` metabolism in patients with essential arterial hypertension (EAH).

Design and method:
The study involved 72 patients suffering from EAH with target-organ damaging, moderate, high or very high cardiovascular risk. Among them, 70.84% (51) women and 29.16% (21) men, mean age 59.87 ± 7,98 y o. The control group involved 50 practically healthy persons, matched by age and sex distribution. To examine polymorphism of AGT (rs699) gene a qualitative polymerase chain reaction was made in real-time regimen. The state of lipids` metabolism was studied by means of determination of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs) content in the blood plasma using diagnostic standard sets produced by „ACCENT-200” firm (Poland).

Results:
The genotypes distribution of the AGT (rs699) gene in patients vs control group did not differ reliably and was as follows: TT- genotype - 13.89% vs 16.67%, TC- genotype - 59.72% vs 54.17% and CC-genotype - 26.39% vs 29.17%, that was corresponded to the Hardy-Weinberg Equilibrium (p > 0.05).
Mean values of TC were higher than that of the normal ones practically in all the groups. The highest parameters were found among TC-genotype carriers, especially among men – 6,14 ± 0,34 mmol/l in the control group and 5,79 ± 0,14 mmol/l in the group of patients with EAH, though there was no reliable difference found between the groups. The level of TGs was higher among T-allele (especially TC-genotype) carriers in comparison with the control group by 50% among men (p = 0,03) and by 25,6% among women. The HDL-C levels were higher than threshold among men-carriers of TT-genotype in both groups, while the carriers of C-allele (especially CC-genotype) had 26,4% (p = 0,01) and 40,2% (p = 0,03) higher values in comparison with TT-genotype carriers. The LDL-C levels were the highest among TC-genotype carriers, but in comparison with other genotype carriers there was no reliable difference found.

Conclusions:
Thus, T-allele of AGT (rs699) gene is associated with a lower HDL-C level in men and a higher level of TGs in women.
ARTERIAL HYPERTENSION (HT) IS ONE OF THE MOST PREDICTIVE RISK FACTORS FOR TYPE 2 DIABETES (DM2). THE FINDRISC IS VALIDATED FOR THE EARLY DETECTION OF SUFFERING FROM DM2
Authors: Mirada Micaela , Pessana Franco , Acuña Maria Isabel Rodriguez , Ramirez Agustin , Sanchez Ramiro 
Published: June 2022

Objective:
To investigate in patients with hypertension the risk of DM 2 according to the criteria of the FINDRISC score

Design and method:
Cross-sectional epidemiological study. 659 subjects between 18–65 years of age, 210 (32%) female and 449 (68%) males were selected. The parametric variables under the studio were: Age, Weight, Height, Central Abdominal Perimeter, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), HDL, LDL, Total cholesterol, triglycerides, Basal blood glucose and the dichotomous variables: Sex, Diet, Exercise, antihypertensive drugs, historical hyperglycemia, family history of DM to evaluate the FINDRISC score. Two multivariate analysis model was used: linear and potential regression, together with logical tests. Excel and JMP were used for the statistical analysis.

Results:
From the group studied, 71% of them were at risk of developing type 2 diabetes mellitus. Among them, 16.2% (107 subjects) presented high and very high FINDRISC score values (15–20 and greater than 20). 25.8% were hypertensives (131 patients), and 36% of them present a high and very high risk FINDRISC score value, compared with only 11% of the normotensive group. When analyzing the population of hypertensive subjects and high risk for diabetes, no differences were observed between male and female (37% male men and 33% female.

Conclusions:
With FINDRISK score, Hypertension is one of the most relevant risk factors to develop diabetes in our population. This makes it possible to plan individual actions in order to achieve a reduction in cardiovascular complications.
THE PREVALENCE OF WHITE-COAT EFFECT AND REVERSE WHITE-COAT EFFECT IN TREATED HYPERTENSIVE PATIENTS
Authors: Lewandowska Katarzyna , Lipski Dawid , Pawlak-Chomicka Regina , Uruski Pawel , Tykarski Andrzej 
Published: June 2022

Objective:
In hypertensive population are patients whose office blood pressure measurements differ from those in 24-hour ambulatory blood pressure measurements. They are patients with the white-coat effect (office blood pressure is higher than office measurements) and with the reverse white-coat effect (ambulatory measurements are higher than office blood pressure measurements). The cardiovascular risk and the prevalence of organ damages in both phenomena are unclear. There are studies showing that these phenomena could be clinically significant. The aim of the study was to assess the prevalence of white-coat effect and reverse white-coat effect in treated hypertensive patients, depending on gender and age.

Design and method:
The office and 24-hour ambulatory blood pressure measurements data were collected from 1465 hypertensive patients (771 men) with mean age 55.9 ± 15.2. The reverse white-coat effect was defined as: office systolic blood pressure – daytime systolic blood pressure mean < -10 mmHg. The white-coat effect was defined as: office systolic blood pressure – daytime systolic blood pressure mean > = 20 mmHg and/or office diastolic blood pressure – daytime diastolic blood pressure mean > = 10 mmHg. Patient data were sorted in accordance with gender and divided into age decades every 10 years. Statistica software (StatSoft) and Microsoft Excel were used to calculate phenomena prevalence.

Results:
300 (20.5%) patients met the reverse and 286 (19.5%) white-coat effect criteria. The prevalence of both phenomena was similar in the treated hypertensive population. The white-coat effect was more common in older patients, with the highest prevalence in the 65–74 age decade (26.3%). The reverse white-coat effect referred to younger patients - predominating was 25–34 age decade (31.9%). Depending on gender, the white-coat effect was dominant among women aged 75–84 (27.4%) and among men aged 65–74 (27.1%). The reverse white-coat effect was dominant among women and men aged 25–44 (appropriate 43.5% and 26.1%).

Conclusions:
The reverse white-coat effect occurs the most often in women and men in the 25–34 age decade. The white-coat effect is the most common among women in 75–84 and among men in the 65–74 age decade.
PREVALENCE AND CONTROL OF HYPERTENSION IN DIABETIC PATIENTS WITH VERSUS WITHOUT CHRONIC KIDNEY DISEASE
Authors: Georgianou E. , Markakis K. , Georgianos P. , Zografou I. , Sachinidis A. , Sabanis C. , Doumas M. 
Published: June 2022

Objective:
Adequate control of hypertension is a guideline based strategy to retard the progression of kidney injury in patients with diabetes. The aim of this cross-sectional study was to compare the prevalence and control rates of hypertension in diabetic patients with versus without chronic kidney disease (CKD).

Design and method:
In 483 outpatients with type 1 or type 2 diabetes from a tertiary university hospital of the region of Thessaloniki, office blood pressure (BP) was recorded under standardized conditions (triplicate recordings after a 5-minute seated rest period) using the validated automated device HEM-705 (Omron, HealthCare). Hypertension was defined as office BP equal as or higher than 140/90 mmHg or current use of at least 1 antihypertensive drug.

Results:
The prevalence of hypertension was 69.8% in diabetic patients with estimated-glomerular-filtration-rate (eGFR) > 90 ml/min/1.73m2, 79.6% in patients with eGFR 60–90 ml/min/1.73m2 and 91.4% in those with eGFR < 60 ml/min/1.73m2 (P< 0.001 for the trend across eGFR strata). Despite the fact that 69.6% of the overall population was being treated with an average of 2.2 antihypertensive drugs daily, the control rates of hypertension were 41.8%, 40.0% and 34.5% in patients with eGFR > 90, 60–90 and < 60 ml/min/1.73m2, respectively (P = 0.245). The decline in eGFR was accompanied by a parallel rise in systolic BP, decline in diastolic BP, and widening of pulse pressure (51.5 ± 14.8 vs. 55.5 ± 16.5 vs. 65.9 ± 17.3 mmHg in the eGFR strata of > 90, 60–90 and < 60 ml/min/1.73m2, respectively, P < 0.001). A similar distribution of the severity of hypertension was observed when the patients were stratified by level of albuminuria.

Conclusions:
The present study shows that among patients with diabetes, the severity of hypertension increases in parallel with the decline in eGFR and rise in albuminuria. The widening of pulse pressure is possibly reflecting the more severe arteriosclerosis in patients with diabetes and established CKD.
EPIDEMIOLOGY OF HYPERTENSION IN CROATIA (EHUH STUDY) -ECG FINDINGS AND CARDIOVASCULAR MORTALITY DATA AFTER 17 YEARS OF FOLLOW-UP
Authors: Frkanec Stjepan , Katic Luka , Strbac Tea , Tarnovski Lorka , Boban Marin , Sekulic Mislav , Stojic Vana , Trobonjaca Adrian , Begic Zvonimir , Barisic Klara , Jelakovic Ana , Blagus Luka , Bosnjak Vito , Gellineo Lana , Stevanovic Ranko , Rak Benedict , Jelakovic Bojan 
Published: June 2022

Objective:
Our aim was to association of ECG findings and mortality data in random sample of Croatian population, an original cohort from the EHUH study after 17 years of follow up.

Design and method:
EHUH study is nation-wide survey on prevalence, treatment and control of hypertension in Croatia. In 2001–2003 a random sample of 1267 subjects were enrolled. Mortality data were analyzed after average period of 17 years. Office blood pressure (BP) was measured in sitting position using mercury sphygmomanometer three times at two visits and once at home visit: total 9 measurements -average BP values were calculated. Mortality data were collected from National Public Health Institute records. ECG scans were taken 17 years ago in 162 subjects and scans were analyzed by 2 different examiners manually, regardless one of another. In this group there were 17 deaths. Heart rate, intrinsic heart rate, RR interval, QT, TPe and QRS times, QTc and TPe/QTc ratios were analyzed across the groups.

Results:
Statistically significant differences were observed in distributions of intrinsic heart rate (p < 0.001) and QTc (p < 0.05) between subjects who died and survivors. Higher values of intrinsic heart rate were linked with lower mortality (B = -0.361, (p < 0.001). A smaller, but statistically significant difference was observed for QRS time (B = -0.045, p < 0.05) suggesting longer QRS times are linked with lower mortality.

Conclusions:
Our results which are not in line with other reports could be explained with small group, small number of events and most probably it is the case of reverse epidemiology.
IMPACT OF COMBINED TREATMENT WITH ACE INHIBITORS AND STATINS ON CARDIOVASCULAR OUTCOMES IN THE BRISIGHELLA HEART STUDY: A 8-YEAR FOLLOW-UP
Authors: Cicero Arrigo F.G. , Fogacci Federica , Rizzoli Elisabetta , Giovannini Marina , D’Addato Sergio , Borghi Claudio 
Published: June 2022

Objective:
The aim of this analysis was to comparatively evaluate the long-term effect of combining treatment with statins and angiotensina-converting enzyme (ACE) inhibitors on hemodynamic and laboratory parameters and on the incidence of major cardiovascular events (MACE) and other clinical outcomes in a well characterized Italian cohort.

Design and method:
We considered data from a subset of Brisighella Heart Study (BHS) participants who were consecutively evaluated in three epidemiological surveys between 2012 and 2020. For the purpose of this analysis, we excluded normotensive subjects and individuals with a low calculated 10-year CVD risk, hypertensive patients treated with antihypertensive drugs different from ACE inhibitors and patients who changed antihypertensive medications during follow-up. The remaining participants were divided into four groups depending on whether they were treated with (I) perindopril +/- amlodipine without statin treatment, (II) perindopril +/- amlodipine and atorvastatin, (III), an ACE inhibitor other than perindopril without statin therapy, (IV) an ACE inhibitor other than perindopril and statin therapy. The long-term (8 years) effects of the different combined treatment were compared among the pre-defined groups.

Results:
Over the follow-up period of 8 years, the proportion of subjects who developed MACE, type 2 diabetes mellitus and hyperuricemia, and the proportion of subjects who had a need for the intensification of antihypertensive treatment to improve blood pressure control were statistically different among the predefined groups (P < 0.05).

Conclusions:
Based on our observations, the combined treatment with ACE inhibitors and statins in hypertensive patients seems to significantly reduce the risk of developing CVD in comparison with treatment with ACE inhibitors alone. This effect seems to be particularly impressive when treatment with perindopril (+/- amlodipine) is as-sociated to atorvastatin.