bluuebunny/crossref_metadata_2025_split huggingface dataset:
PARAMETERS INDICATING DEVELOPMENT OF HYPERTENSION IN THREE-YEAR FOLLOW-UP STUDY OF SUBJECTS WITH HIGH NORMAL BLOOD PRESSURE
Authors: Kalos Theodoros , Dimitriadis Kyriakos , Konstantinidis Dimitrios , Siafi Eirini , Kariori Maria , Kakouri Niki , Manta Eleni , Tatakis Fotis , Polyzos Dimitrios , Drogkaris Sotiris , Zammanis Ioannis , Fragoulis Christos , Andrikou Ioannis , Tsioufis Konstantinos 
Published: June 2022

Objective:
Assess the relation of hypertensive response to exercise (HRE) in subjects with high normal blood pressure (BP) while sympathetic overactivity assessed by muscle sympathetic nerve activity (MSNA) and arterial stiffening are linked with development of hypertension (HTN).

Design and method:
100 consecutive subjects with high normal BP [systolic BP = 130–139mmHg and/or diastolic BP = 85–89mmHg], underwent a negative for ischemia treadmill exercise test (Bruce protocol). Arterial stiffness was evaluated using carotid-femoral pulse wave velocity (PWV). Sympathetic drive was assessed by MSNA. Follow-up was scheduled every 6 months for 3 consecutive years, where BP measurements were assessed in office and with ambulatory BP monitoring (ABPM). All participants offered lifestyle advice. Endpoint was development of HTN either with OffBP or ABPM. We divided into Group I those who developed HTN and Group II without HTN.

Results:
From 100 subjects (54 ± 8 years, 42 males, baseline OffBP: 132/82 mmHg, 24-hour BP: 122/76 mmHg) 40 developed HTN (Group I) and 50 developed HRE (BP> or = 210mmHg in men and > or = 190mmHg in women). Group I vs II had higher HRE (75%vs13%, p = 0.026) with intermediate stage intervals of 3 min (160vs147mmHg, p = 0.068) and 6 min (181vs164mmHg, p = 0.035). The SBP/MET-slope [(peakSBP—restingSBP)/(peakMET-1)] in Group I was increased in all stages till peak exercise (stage1: 6.25vs4.25, stage2: 7.6vs5.3, peak: 7.22vs5.1, p = 0.035). Their exercise capacity was reduced (10vs11.5METs) as their maximum exercise heart rate (154vs164, p = 0.001). They demonstrated higher levels of PWV (8.35vs7.5m/sec, p = 0.043) and MSNA levels (37vs31 bursts, p = 0.04), while did not differ regarding their metabolic profile at the follow-up. Echocardiographicly LVMI did not differ, but LVEDD (47vs45 mm, p = 0.02), E/A ratio of mitral valve inflow (0.92vs1.05, p = 0.034) and left atrium diameter (3.8vs3.6 mm p < 0.1) were statistically significant. At their initial ECG had shorter P-wave duration (101.3vs93.2, p = 0.013) and QRS duration (93.4vs85.7, p = 0.006). In ABPM they demonstrated higher night systolic BP (116vs112mmHg, p < 0.04).

Conclusions:
In subjects with high normal BP, MSNA identifies a state of increased sympathetic overdrive, PWV demonstrates arterial stiffening and exercise testing proves its prognostic value as a hypertension predictor screening tool acknowledging a state of increased systemic vascular resistance.
THE SIZE OF BLOOD PRESSURE MEASUREMENT REDUCTION IN THE UNATTENDED AUTOMATED BLOOD PRESSURE MEASUREMENTS IS CORRELATED WITH THE LEVEL OF ANXIETY
Authors: Stopa Marek , Zieba Katarzyna , Tofilska Anna , Korpala Barbara Betkowska , Rajzer Marek , Olszanecka Agnieszka 
Published: June 2022

Objective:
Accurate and precise measurement of blood pressure [BP] is critical for both diagnostics and guiding clinical decisions in arterial hypertension. Unattended automated blood pressure measurement [UABPM] can simplify the measurement process, reducing human error and minimizing the white coat effect. The purpose of this study was to analyze the differences in BP between office attended [oABPM] and UABPM and examine their relation with the level of anxiety.

Design and method:
We conducted a prospective study in the group of 124 hypertensive outpatients (56 % female, mean age 55,3 ± 12,3 years). Each patient had been asked to fill out a health questionnaire and perform the State-Trait Anxiety Inventory, a standardized psychological questionnaire measuring level of anxiety. Afterward, BP was measured using two methods with random order:
oABPM – after 5 minutes of rest 3 measurements in 1-minute intervals were taken by a doctor
UABPM – after programming the device by a doctor, patient was left alone, after 5 minutes the device performed 3 measurements in 1-minute intervals.
Differences in BP were compared using paired sample t-test. Correlation between differences and level of anxiety was nalysed using Pearson correlation coefficient.

Results:
In UABPM both systolic and diastolic BP values were significantly lower than in oABPM (4,19 ± 6,48 mmHg, p < 0,001 and 2,04 ± 3,34 mmHg, p < 0,001, respectively). These differences t were more pronounced in the group that had attended measurements taken first (5,98 ± 6,57 mmHg, p < 0,001 for systolic and 3,11 ± 3,52 mmHg, p < 0,001 for diastolic). In this group, significant correlation between systolic BP and level of anxiety was found (r = 0,27, p = 0,047). In multiple regression female sex (B = -4,62, p < 0,001 for systolic and -1,19, p = 0,042 for diastolic) and order of measurements (B = 3,63, p < 0,001 for systolic and 2,06, p < 0,001) for diastolic) were most significantly influencing BP differences between compared methods.

Conclusions:
Routine clinic measurements can overestimate BP values and the difference in oABPM and UABPM partly depends on the level of anxiety. Accurate BP measurement has important implications for treatment decisions like dose and/or drug escalation.
TENSIOBOT: A CHATBOT ASSISTANT FOR SELF-MANAGED IN-HOUSE BLOOD PRESSURE CHECKING
Authors: Ramón Saracho , Echeazarra Leyre , Pereira Juan Antonio 
Published: June 2022

Objective:
Patients with HBP are often asked to have their BP checked at home. The traditional at-home procedure has some drawbacks, such as forgetting to check or write down the values, errors in transcribing the numbers, or the impossibility of immediately notifying medical staff of out-of-range BP values. To facilitate self-measurements by patients at home we devised TensioBot, a Telegram based chatbot. The bot sends patients reminders to check their BP, advice on good monitoring practices, measurement tracking, medical alerts and allows healthcare professionals to access up-to-date measurement information. The aim of our study was to compare the use of Tensiobot against usual method of home BP checking.

Design and method:
In an Clinical Hypertension Unit, we tested TensioBot for two years in a andomised controlled trial with 112 patients, 55 using the bot and 57 in the control group, (using paper annotations). Patients of both groups underwent an ABMP study at the same time. An specific questionnaire about knowledge and skills on BP checking was administered face to face by an specialized nurse of the unit.

Results:
We found that, although the bot group showed similar results in terms of adherence to the BP checking schedule, bot users scored better in terms of knowledge and skills on BP checking best practices. Patients of bot group shown a lesser mean difference between ABPM mean diurnal SBP and SBP registered by Tensiobot, -0.34 mmHg vs -2.5 mmHg, although such difference was not significant. The standard deviation of differences in SBP was higher in the control group.

Conclusions:
Participants rated the bot very positively, perceived it as useful and easy to use, and continued to use it after the intervention. Moreover, all data being equal, we describe some other benefits of using a chatbot for self-managed in-house BP control, both for patients and healthcare professionals and systems. There was a trend to closer values to diurnal ABPM in SPB using the bot.
COMPARISON OF OFFICE, HOME AND AMBULATORY BLOOD PRESSURE MEASUREMENT IN HYPERTENSIVE PARTICIPANTS IN THE POPULATION-BASED SWISS LONGITUDINAL COHORT STUDY (SWICOS)
Authors: Radovanovic Dragana , Schoenenberger-Berzins Renate , Muggli Franco , Gallino Augusto , Parati Gianfranco , Suter Paolo , Bianchetti Mario , Erne Paul , Schoenenberger Andreas 
Published: June 2022

Objective:
The 2021 guideline of the ESH states that a reliable hypertension diagnosis should not be based on office BP measurement solely, but should be confirmed with the use of home BP measurement (HBPM) or 24 h ambulatory BP measurement (ABPM). The aim of our study was to compare BP measurements obtained in the office (OBPM), at home (HBPM) and ambulatory (ABPM) in individuals with elevated OBP participating in the Swiss Longitudinal Cohort Study (SWICOS).

Design and method:
Participants with OBP = > 140/90mmHg were invited to assess their BP using HBPM and ABPM. The cut-off for hypertension was = > 135/85 mmHg for HBPM and = > 130/80 mmHg for ABPM. White-coat hypertension (WCH) was defined as normal HPBM or ABPM in the subgroup of participants who had OBP = > 140/90mmHg. Undertreatment was defined as hypertension in HBPM or ABPM despite antihypertensive treatment.

Results:
Of 72 hypertensive participating subjects with office BP = > 140/90mmHg and valid measurements of HBPM and ABPM, 39 were males (aged 62.8 ± 11.8y) and 33 were females (aged 57.4 ± 14.2y). Systolic BP measured in the office (151.7 ± 15.5 mmHg) was significantly higher than values measured using HPBM (130.0 ± 13.5 mmHg) (p < 0.001) or during ABPM (131.8 ± 14.7 mmHg) (p < 0.001). Diastolic BP was also highest in the office (89.3 ± 8.0 mmHg) and significantly different from HBPM (81.6 ± 6.6 mmHg) or ABPM (80.8 ± 11.2 mmHg) (both p < 0.001). Hypertension was confirmed with HBPM in only 21 participants (29%), and with ABPM in 41 participants (57%). Participants who had hypertension according to ABPM but not to HBPM were significantly younger (p < 0.001) and more frequently working (p < 0.001). The prevalence of WCH was 44% using HBPM and 26% using ABPM. Undertreatment was found in 13 participants (18%) using HBPM and 21 (29%) using ABPM.

Conclusions:
This study found highest BP for OBPM; HBPM and ABPM were significantly lower. Hypertension prevalence was lower using HBPM than using ABPM in young working participants. Potentially, HBPM might lead to underdiagnosis and undertreatment. Nevertheless, the findings of this study support the ESH recommendations of complementing office BP using HBPM or ABPM given the high prevalence of WCH and undertreatment.
AMBULATORY BLOOD PRESSURE MEASURMENT INTEREST IN GENERAL PRACTICE
Authors: De La Rue Du Can Arthur , Rey Jean-Marie , Ormezzano Olivier 
Published: June 2022

Objective:
International societies recommend out of office blood pressure (BP) measurement to confirm and follow hypertension (HT). In France Ambulatory blood pressure monitoring (ABPM) is usually used only by cardiologists or hypertensive specialists. However a majority of hypertensive patients are seen by general practitioners GP’s. The objective of our study was to evaluate ABPM interest in GP’s daily practice.

Design and method:
This is a retrospective, monocentric, observational study including all consecutive patients undergoing ABPM in a GP’s surgery in Grenoble.
The study groups were divided in three depending on ABPM indications:
- Screening of normal clinical blood pressure patients with high cardiovascular risk factors (SNBPP)
- Diagnosis in unknown hypertensive patients with elevated clinical BP (DHBPP)
Follow up of known treated hypertensive patients (HPP).

Results:
422 subjects ABPM were analysed. ABPM changed 43% patient BP status.
- Among SNBPP (35 subjects) 49% presented masked HT.
- Among DHBPP (158 subjects) 41% presented white coat HT. Systolic and diastolic office BP were significantly higher in confirmed hypertensive patients (p = 0.01 and < 10–4 respectively).
- Among HPP (229 subjects) 16% presented controlled BP, 33% presented white coat HTN, 11% masked HTN, 40% uncontrolled HT. Number and type of medications were not statistically correlated with BP control.
Dipping profil: 40.4% of patients were dippers, 40.2% were non dippers, 9.9% were reverse dippers, and 9.4% extreme dippers. Dipping variations were statistically different over the 3 groups (p < 10–4).

Conclusions:
ABPM is a great tool for GP’s to characterise accurately BP profil, and improve follow up and monitoring of patients.
BLOOD PRESSURE CONTROL RATES PREVIOUS AND DURING THE COVID-19 PANDEMIC IN BRAZIL
Authors: Lima Lucas , Vitorino Priscila , Silva Suelen , Sousa Ana , Barroso Weimar 
Published: June 2022

Objective:
to compare the previous blood pressure control rates with those assessed during the COVID-19 pandemic.

Design and method:
two cross-sectional studies (march to November 2019 and march to November 2020). Participated patients from health centers of five Brazilian regions that used the TeleMRPA platform to report tests on people diagnosed with and under control of arterial hypertension, aged between 18 and 100 years, included. Data from patients with duplicate or inaccurate information excluded. Blood pressure control measures < or = 140/90 mmHg considered for casual measurements and/or < or = 130/80 for residential measurements.

Results:
38.698 patients evaluated, 54.7% in 2019 and 43.9% from northeastern Brazil. There was an increase in patients not using antihypertensive drugs from 52.5% in 2019 to 61.3% in 2020 (p < 0.001) and BMI from 28.1 (± 4.5) to 28.3 (± 4.5) p = 0.010. We did not identify differences in the comparison of SBP (office and MRPA) between the two periods evaluated. There was an increase in DBP both in the office from 83.8 (±11.8) to 84.5 (±11.9), p < 0.001 as that obtained by the MRPA from 79.25 (±9.58) to 79.57 (±9.68), p = 0.001. The variability of DBP reduced from 5.9 (±2.49) to 5.9 (±2.43), p < 0.001, and the mean Pulse Pressure was 50.7 (±14.4) in 2019 to 50.3 (±14.3) in 2020, p = 0.009. There was no change in the control rates considering the office measure which was from 68.9% to 68.6% and the MRPA from 52.4% to 51.4% from 2019 to 2020.

Conclusions:
blood pressure control remained stable during the COVID-19 pandemic when compared to the previous year. Assessing and monitoring blood pressure control through telemonitoring using home blood pressure monitoring is a simple, easy-to-access, and effective method.
SUBCLINICAL MAGNETIC RESONANCE IMAGING MARKERS OF CEREBRAL SMALL VESSEL DISEASE IN RELATION TO AMBULATORY BLOOD PRESSURE MEASUREMENTS
Authors: Melgarejo Jesus , Maestre Gladys E. , Gutierrez Jose , Thijs Lutgarde , Mena Luis , Gaona Ciro , Reinier Leendertz , Lee Joseph , Chavez Carlos , Calmon Gustavo , Silva Egle , Wei Dongmei , Terwilliger Joseph , Vanaasche Thomas , Janssens Stefan , Verhamme Peter , Bos Daniel , Zhang Zhenyu 
Published: June 2022

Objective:
24-h and nighttime blood pressure (BP) levels are the strongest BP measurements associated with cardiovascular risk. However, it remains undocumented which of the ambulatory BP measurements have the strongest association and predictive information in relation to the presence of cerebral small vessel diseases (CSVD).

Design and method:
A subset of Maracaibo Aging Study with 429 participants [aged 40 years or older (women, 73.7%; mean age, 59.3y)] underwent baseline brain magnetic resonance imaging to visualize CSVD, which included log-transformed white matter hyperintensities (log-WMH), the presence (yes/no) of silent brain infarcts (SBI), cerebral microbleeds (CMB), or enlarged perivascular spaces (EPVS). Linear and logistic regression models were applied to examine the association between CSVD and each + 10 mmHg increment in the office and ambulatory systolic BP. Improvement in the fit of nested logistic models was assessed by the log-likelihood ratio and the generalized R2 statistic.

Results:
Office and ambulatory systolic BP measurements were related to log-WMH (beta correlation coefficients above 0.08; P < 0.001). SBI and CMB were only associated with ambulatory systolic BP measurements (odds ratios [OR] ranged from 1.31 [95% confidence interval, 1.10 1.55] to 1.46 [1.17–1.84], P < 0.003). Accounted for daytime systolic BP, both the 24-h (beta correlation, 0.170) and nighttime (beta, 0.038) systolic BP measurements remained related to log-WMH. When accounted for 24-h or daytime systolic BP levels, the nighttime systolic BP retained the significant association with SBI (ORs, 1.05–1.06; 95% CIs, > = 1.01to< = 1.13), whereas the 24-h and daytime systolic BP levels were not associated with SBI after adjustments for nighttime systolic BP (ORs, < = 0.88; 95% CI, > = 0.77to< = 1.14). On top of covariables and office systolic BP, ambulatory systolic BP measurements significantly improved model performance (R2<3.82%). Compared to 24-h and daytime SBP, nighttime systolic BP had the strongest improvement in the model performance; for WMH (1.46% vs. 1.05%) and SBI (3.06% vs. below 2.05%).

Conclusions:
24-h and nighttime systolic BP were the more robust BP measurements associated with CSVD, but for log-WMH and SBI, the nighttime systolic BP level had the strongest association. Controlling ambulatory BP levels might provide additional improvement in the prevention of CSVD
EFFECT OF MENTAL RELAXATION ON OFFICE BLOOD PRESSURE MEASUREMENT BY OSCILLOMETRY
Authors: Gupta Sanjay , Gupta Sangeeta , Gupta Kashish 
Published: June 2022

Objective:
Automated office Blood pressure (AOBP) has become the standard of care method of measuring blood pressure. ESC/ESH Clinical Practice Guidelines for the management of arterial hypertension 2018 specifies that Patients should be seated comfortably in a quiet environment for 5 min before beginning BP measurements. However, a variety of visual and auditory stimuli during this period can still result in higher BP recordings. Mental Relaxation induced by reducing visual stimuli and soothing sounds can potentially have an effect on the AOBP recordings. The study aims to evaluate this effect and compare it to the standard protocol of BP measurement.

Design and method:
198 consecutive patients were evaluated in the outpatient department. BP was measured by oscillometric method using Microlife BP device following the ESC/ESH guidelines. Patients were seated in a comfortable posture with back and feet supported for a period of 15 minutes before BP measurement. Mental relaxation was induced by reducing visual stimuli using eye shades and ear phones playing soft natural sounds and second set of BP and pulse recordings were done at the end of 5 minutes of relaxation time. Unpaired t test and Chi-Square test were utilized for the statistical analysis.

Results:
There were 96 males and 102 females with mean age of 53.13 ± 13.95 yrs
History of hypertension was present in 105 subjects
Using standard BP measurement protocol the mean systolic BP was 142.33 ± 18.85 mm hg, mean diastolic BP was 83.22 ± 8.5 mm hg and mean pulse rate was 84.55 ± 15.27 per minute.
The mean change after Mental relaxation augmented period was 6.71 ± 13.66 mm hg in systolic BP (p value 0.0001), 2.85 ± 7.67 mm hg in diastolic BP (p value 0.0001) and 2.81 ± 8.71 per minute in pulse rate (p value 0.0001)

Conclusions:
Mental relaxation augmented physical rest before measurement of BP by oscillometric method in outpatient clinic results in significant reduction in BP (both systolic and diastolic) and pulse rate compared to standard BP measurement protocol. These values may be more realistic as they are likely to have reduced white coat effect and environmental influences.
ADVANTAGES AND LIMITATIONS OF USING THE AKTIIA CUFFLESS BRACELET FOR A HYPERTENSION SPECIALIST
Authors: Girerd Xavier , Boualit Robert , Pathak Atul , Perruchod David , Sola Josep 
Published: June 2022

Objective:
The AKTIIA bracelet was the first cuffless blood pressure monitor available in Europe over the counter. While published medical data show the validity of the measurement system compared to traditional blood pressure measurements, the objective of this preliminary study was to assess the value of the AKTIIA bracelet in the care of treated hypertensive patients.

Design and method:
Two bracelets were provided by the manufacturer to university cardiologist, specialist in hypertension. They were assigned to two hypertensive patients treated with antihypertensive drugs: one 62 years old treated with nebivolol 5 mg for 1 month and then with nebivolol 5 mg + candesartan 4 mg for the following 2 months, the other 52 years old treated with irbesartan 150 mg for 3 months. They were instructed to wear the bracelet for 3 consecutive months and following the manufacturer’s instructions to perform a calibration on 3 occasions. The patients performed also home blood pressure monitoring for 3 days with 6 measures per day once a month while wearing the bracelet on the other arm.

Results:
Over the same time periods, SYS/DIA values were accurately comparable between the AKTIIA bracelet and HBPM

Conclusions:
The AKTIIA bracelet, the first cuffless blood pressure monitor available in Europe over the counter, is currently proposed for blood pressure monitoring in healthy subjects. Its technological properties make it possible to use it for the follow-up of patients treated for hypertension. Some evolutions are desirable to facilitate its use by hypertension specialists. The cuffless method which allows blood pressure measurements without disturbing sleep constitutes a breakthrough in the management of hypertensive patients.
CLOSE VERSUS LOOSE CONTACT BETWEEN PHYSICIAN AND PATIENT DURING ATTENDED OFFICE BLOOD PRESSURE MEASUREMENT: DOES IT PLAY A ROLE?
Authors: Filipovsky Jan , Seidlerova Jitka Mlikova , Kordikova Veronika 
Published: June 2022

Objective:
Compared to unattended office blood pressure measurement (uOBP), attended office blood pressure measurement (aOBP) gives higher blood pressure (BP) values. It is not known, however, to what extent the distance between physician and patient during aOBP influences BP.

Design and method:
Participants were stable hypertensive patients, followed in the university hospital-based out-patient centre. During a session, automated office BP was measured three times after a pre-set five-minute pause, using Omron 907 device; both aOBP and uOBP were done, in a random order. Simultaneously, beat-to-beat BP measurement (bbBP) was done using Finapress device. During aOBP, some participants were in close contact with the physician: he placed the stethoscope to the cubital fossa, thus imitating the auscultatory measurement; other patients were in “loose’’ contact where the doctor was sitting in the room, about two meters apart. One year later, the second session with the same protocol was organized, but the close and loose contact were interchanged. The data were analysed using a paired t-test.

Results:
Complete data were collected in 32 patients (53% males, age 66.2 ± 8.1 years, uOBP 122.8 ± 14.8 / 69.5 ± 11.7 mmHg, treatment with 2.7 ± 1.0 antihypertensive drugs). Systolic and diastolic aOBP with close contact was higher by 4.6 ± 6.9 and 1.9 ± 3.4 mmHg (p < 0.0007 and 0.0039, respectively), while aOBP with loose contact was not different from uOBP.
bbBP increased during aOBP by up to 6.5 ± 8.5 / 3.3 ± 4.8 mmHg, as compared to baseline BP values measured before the physician entered the office. The increase persisted during all the three aOBP measurements (p < 0.001 for all systolic and diastolic BP values); the results were similar for close and loose contact. The peak increase during uOBP was of similar magnitude as during aOBP but it lasted shorter: it increased highly significantly (p < 0.001) only during the first uOBP measurement.

Conclusions:
Compared to uOBP, aOBP values were higher with close, but not with loose contact between physician and patient. These differences were, however, not detected by bbBP measurement.