bluuebunny/crossref_metadata_2025_split huggingface dataset:
TAKOTSUBO SYNDROME REVEALING PHEOCHROMOCYTOMA
Authors: Cordeanu Elena-Mihaela , Mirea Corina , Tousch Jonathan , Ohlmann Patrick , Vix Michel , Diaye Gora N. , Henriette Victor , Stephan Dominique 
Published: June 2022

Objective:
We report the case of 57-year old woman with no previously known cardiovascular disease.

Design and method:
Her conventional cardiovascular risk factors were type 2 diabetes (HbA1c< 6.5%), hypertension and active smoking. She presented to the ER for thoracic pain, headache, sweating and tachycardia (150 bpm).

Results:
Blood analysis showed an elevation of cardiac biomarkers (Troponin 2035ng/l; BNP 541ng/l, Ddimers 19500ug/l), and acute renal impairment (creatinin 158umol/l) while EKG showed inferior NSTEMI. Echocardiography visualized typical takotsubo aspect with apical hypokinesia. Thoraco-abdominal CT-scan showed an important left adrenal tumor. Plasmatic and urinary metanephrine and normetanephrine were high. The patient benefited from adrenal surgery with an optimal result on blood pressure control.

Conclusions:
Although the association TTS-pheochromocytoma has already been described, it remains uncommon. Catecholamine excessive secretion mediates TTS cardiomyopathy having a negative impact essentially on apical segments increasing wall stress and pressure, but different ventricular segments may be concerned as individual adrenoreceptors distribution patterns vary. TTS diagnosis should legitimate pheochromocytoma screening when associated with labile hypertension.
COMPARISON BETWEEN DISTINCT INSULIN RESISTANCE INDICES IN MEASURING THE DEVELOPMENT OF HYPERTENSION: THE CHINA HEALTH AND NUTRITION SURVEY
Authors: Yuan Yue , Sun Wei , Kong Xiangqing 
Published: June 2022

Objective:
The link between insulin resistance (IR), obesity and the development of hypertension is well known. This study aimed to identify the relationship between several surrogate IR indices based on lipid products and the development of hypertension.

Design and method:
A total of 4797 participants aged 18 years or older enrolled in the China Health and Nutrition Survey from 2009 to 2015 were included in final analysis. Logistic regression was used to analyze the association between different IR indices and the presence of hypertension.

Results:
There were 1972 (41.1%) hypertensive participants in 2015. With regard to the homeostasis model assessment of insulin resistance (HOMA-IR) based on insulin level, subjects in the highest quartile of HOMA-IR values were more likely to develop hypertension [OR = 1.45(1.18–1.78), P < 0.001] in the fully adjusted model. Subjects in the highest quartile of the triglyceride glucose index (TyG) combined with body mass index (BMI) and waist circumference (WC) had more than 3 times the risk of hypertension after full adjustment compared with individuals in the lowest quartile (both P < 0.001), and the trend continued when adjusted for the HOMA-IR. Compared with those in the lowest quartile of HOMA-IR values, men in the highest quartile had a higher risk of developing hypertension than women [2.05 (1.59–2.64) vs. 1.97 (1.54–2.51)] after the full adjustment, which is the opposite of the association between the six lipid-based products and incident hypertension by sex.

Conclusions:
The results from our large-scale study elucidate the superiority of the TyG-BMI and TyG-WC compared with the HOMA-IR in hypertension prediction, which may be related to lipid deposition. The sex-specific predictive value is distinct for different IR indicators.
MEASUREMENT OF PULSE WAVE VELOCITY IN HEMODIALYSIS PATIENTS
Authors: Khadhar Meriam , Kheder-Elfekih Renia , Jebali Hela , Ikram Mami , Lilia Ben Fatma , Wided Smaoui , Media Krid , Soumaya Beji , Karim Zouaghi 
Published: June 2022

Objective:
Cardiovascular complications represent the leading cause of death in chronic kidney disease.
These patients combine classical and unconventional cardiovascular risk factors. Arterial stiffness, assessed by measuring the pulse wave velocity (PWV), is a reliable means of assessing cardiovascular risk. It has been rarely studied in hemodialysis patients.
The purpose of our study was to evaluate the level of arterial stiffness by measuring carotid-femoral pulse wave velocity in a population of chronic hemodialysis patients and to investigate factors contributing to arterial stiffness.

Design and method:
We conducted a cross-sectional, descriptive study concerning the carotid-femoral pulse wave in hemodialysis patients during two years.

Results:
Our population included 38 chronic hemodialysis patients. Mean duration of hemodialysis was 29.21 ± 24.56 months. The mean age was 49 ± 13 years (16–78 years). Twelve patients were hypertensive (31.6%). Mean arterial pressure was 95 ± 13.5 mmHg. Hemoglobin value was 9.20 ± 1.66 g / dl. PTH was 714 ± 573 ng / l.
PWV was 9.03 ± 2.73 m / s (5–16 m / s). Univariate analysis concluded that PWV acceleration was correlated with age, history of stroke, history of coronary artery disease, diabetes, HTA, elevated PTH and elevated CRP.

Conclusions:
A better understanding of factors influencing arterial stiffness, allows to intensify primary and secondary prevention in hemodialysis patients.
ADIPOSITY AND VASCULAR AGEING: WHICH PARAMETER BETTER CORRELATES?
Authors: Guareschi Alessandro , Vicenzi Marco , Calcagnino Margherita , Carugo Stefano , Scuteri Angelo 
Published: June 2022

Objective:
The increase in stiffness of large arteries is one of the mechanisms that could play a role in the association between obesity and increased risk of cardiovascular (CV) events. Carotid-femoral pulse wave velocity (cfPWV) represents a validated measure of large arteries stiffness and a good proxy of arterial ageing. We aimed at evaluating which body composition parameters better correlated with cfPWV and whether this correlation differed between men and women.

Design and method:
cfPWV was measured in all subjects; body composition was evaluated by bioimpedance analysis and waist circumference (W). Furthermore, each subject was characterized by sex, age, height, weight, body mass index (BMI), brachial blood pressure (BP) and heart rate. A linear correlation was used to define the relationship between cfPWV and parameters. Univariate and multivariate analysis were performed in male and female subgroup separately to select the main determinants of arterial stiffness, considering the following parameters: age, mean BP (mBP), BMI, W, fat mass (FM) and skeletal muscle mass (SMM). We enrolled 69 subjects (37 men, 32 women) with average age 34.5 years (min 19-max 76).

Results:
cfPWV was significantly correlated with age (r = 0.65, p < .0001), and mBP (r = 0.38, p < .01). Among the body composition parameters, W, BMI and FM percentage were significantly correlated with cfPWV (respectively: r = 0.48, r = 0.42, r = 0.41; p < .0001). Multivariable regression analysis in men revealed that age and mBP were significant determinants of cfPWV (respectively: b = 0.042, p = 0.002; b = 0.051, p = 0.004). Conversely, multivariate analysis in women showed that age, FM and SMM are retained as main determinants of increased cfPWV (respectively: b = 0.079; p < 0.0001; b = 0.217, p = 0.012; b = 0.125, p = 0.011).

Conclusions:
Irrespectively of gender, age is the main determinant of arterial stiffness. Our results demonstrated that the relationship between adiposity and arterial stiffness is verified only in female subjects. This suggests that this relationship is influenced by complex and not fully known mechanisms. Moreover, technical factors (algorithm and indirect methods to assess body composition) contribute to uncertainty regarding which parameter exploring adiposity is more accurate in stratifying CV risk. The present study recalls attention on possible gender-specific determinants of arterial ageing.
LACK OF LIFESTYLE MODIFICATIONS IN GLOBAL HYPERTENSION MANAGEMENT
Authors: Vay-Demouy Juliette , Blacher Jacques , Olie Valérie 
Published: June 2022

Objective:
The aim of this study is to analyze the role of lifestyle modifications in global arterial hypertension management in France.

Design and method:
This retrospective cross-sectional study is an analysis of the database of ESTEBAN study which was led by Santé Publique France from 2014 to 2016 on a representative sample of the French population. Our study focused on the aware hypertensive adults of the ESTEBAN final sample: 440 participants aged 18 to 74. The main criteria are the proportion of participants who received lifestyle advice(s) in their overall arterial hypertension management, with or without associated pharmacological treatment, and the proportion of recommendations of the three main lifestyle advices: physical activity practice, weight reduction and dietary modifications.

Results:
More than half (57%) of participants declared not to have received any lifestyle advice in the framework of their arterial hypertension management, including 39% who were not treated pharmacologically (Figure 1). Physical activity practice was recommended to 31.8% of sedentary participants and weight reduction to 26.8% of overweight participants. Less than a quarter (20.1%) received dietary recommendations (Figure 2), 69% of them for the limitation of salt intake and 10.7% for the limitation of alcohol intake.

Conclusions:
Lifestyle modifications remain too rarely recommended. Time of a medical visit is probably too short, although lifestyle advices should be discussed with the hypertensive patient at the time of diagnosis and throughout the follow-up, with the triple goal of a more efficient treatment, a better treatment persistence and finally a better blood pressure control.
GEOGRAPHICAL ANALYSIS OF HYPERTENSION IN CANADIAN POPULATION
Authors: Leroux Denis , Cloutier Lyne 
Published: June 2022

Objective:
A quarter of population is affected by hypertension in Canada. Substantial improvement has been achieved in HTN control in Canada over the past twenty-five years. However, disparities associated with factors like sex, ethnicity, location and health care access remain. Reliable information about trends in hypertension is needed at regional scale for the development of health policies and programs. Health geography and geographic information systems can provide a better understanding of HTN and its risk factors by detecting clusters using spatial analysis and mapping rates of HTN. The objectives of the study were to identify health regions with significantly high or low HTN rate using geostatistics and compare evolution from 2005 to 2019. It also seeks out to identify their populations’ characteristics using conventional statistical analysis.

Design and method:
Canadian Community Health Survey (2005, 2015, 2019) data were used for the analysis. The 130,000 respondents are located according to health regions and data can be analyzed using a geographic information system. Using age and gender as criteria for subgroups creation, we applied spatial autocorrelation analysis and hot spot/cold analysis to identify geographically contiguous health regions with high or low HBP rates. We then extracted the records in CCHS database for all respondents living in these regions for further statistical analysis.

Results:
HTN is still a major problem in Canadian population, especially for people aged 65 years and older although 72.9% considered themselves in good, very good or excellent health in 2015. Increase in HTN rate in health regions is spread all over Canada, although some regions showed a decrease in HTN rate. Getis-ord analysis located a cold spot region in western Canada while a hot spot was located in Ontario, central Canada. Cluster of health regions with high HTN rates shows more diabetes and more obese people even though 38.4% declared being in good, very good or excellent health.

Conclusions:
Increase in hypertension rate in health regions is spread all over Canada, even tough some regions showed a decrease in HBP rate.
Canadians 65 years and older with HBP where more prone to obesity & diabetes.
PREVALENCE, PHENOTYPES AND CONTROL OF HYPERTENSION IN END-STAGE KIDNEY DISEASE PATIENTS UNDERGOING PERITONEAL DIALYSIS
Authors: Vareta Georgia , Georgianos Panagiotis , Vaios Vasilios , Sgouropoulou Vasiliki , Roumeliotis Stefanos , Georgoulidou Anastasia , Dounousi Evangelia , Eleftheriadis Theodoros , Papagianni Aikaterini , Balaskas Elias , Zebekakis Pantelis , Liakopoulos Vassilios 
Published: June 2022

Objective:
Prior studies conduced in peritoneal dialysis (PD) patients in late 1990 s provided considerably variable estimates of the prevalence and control of hypertension. The present study aimed to investigate the current state of hypertension management in this high-risk population.

Design and method:
In 140 stable PD patients, we performed standardized automated office blood pressure (BP) measurements and 24-hour ambulatory BP monitoring (ABPM) using the Mobil-O-Graph device (IEM, Germany). Hypertension was defined as: (a) office BP equal or higher than 140/90 mmHg; (b) 24-hour BP equal or higher than 130/80 mmHg. Patients treated with at least 1 BP-lowering medications were also classified as hypertensives.

Results:
The prevalence of hypertension was 92.9% using office BP and 95% by ABPM. In all, 92.1% of patients were being treated with an average of 2.4 BP-lowering medications daily. Adequate BP control was achieved in 52.3% and 38.3% of hypertensives by office BP and ABPM, respectively. The agreement between these 2 techniques in the identification of patients with BP levels above the diagnostic thresholds of hypertension was moderate (k-statistic: 0.524). In all, 5% of patients were normotensives with both techniques, 31.4% had controlled hypertension, 5% had white-coat hypertension, 19.3% had masked hypertension and 39.3% had sustained hypertension. Isolated nocturnal hypertension was detected in 23.6% of patients, whereas no patient had isolated hypertension during daytime.

Conclusions:
Among PD patients, hypertension is highly prevalent and remains often inadequately controlled. The use of ABPM enables the better classification of the severity of hypertension and identification of isolated nocturnal hypertension, which is a rather common BP phenotype in the PD population.
ELECTROCARDIOGRAM CHANGES IN PREHYPERTENSIVE SUBJECTS – EPIDEMIOLOGY OF HYPERTENSION IN CROATIA-1 (EH UH-1) STUDY
Authors: Frkanec Stjepan , Katic Luka , Strbac Tea , Trobonjaca Adrian , Jelakovic Ana , Djapic Kresimir , Domislovic Viktor , Gellineo Lana , Rak Benedict , Tarnovski Lorka , Jelakovic Bojan 
Published: June 2022

Objective:
The aim of this study was to analyze the characteristics and changes in the ECG findings of adults with prehypertension (PHT) in a random sample of the general population included in the EH-UH 1 project.

Design and method:
Epidemiology of hypertension in Croatia 1 (EH UH-1) study is nation-wide survey on prevalence, awareness, treatment and control of hypertension (HT) in Croatia. In 2001–2003 a random sample of 1267 subjects were enrolled. Mortality data were analyzed after average period of 17 years. In this sub-analysis we included 189 untreated subjects whom GPs did an ECG. Subjects were divided into 3 groups: optimal blood pressure (OBP) < 120/80 mmHg (N = 42), PHT 120–139/80–89 mmHg (N = 78) and untreated HT (UHT) > = 140/90 mmHg (N = 69).

Results:
Atrial fibrillation was found in 2%, 3% and 4% in OBP, PHT and UHT group, respectively (PHT vs OBP p < 0.05). QTc interval was prolonged in 2%, 13% and 65% in OBP, PHT and UHT group, respectively (PHT vs OBP p < 0.05; UHT vs PHT p < 0.01). Tpe interval was elevated in 12%, 14% and 17% in OBP, PHT and UHT group, respectively. Left ventricular hypertrophy (Cornell) was diagnosed in 5%, 9%, and 13% in OBP, PHT and UHT group, respectively (PHT vs OBP p < 0.05; PHT vs UHT p < 0.05).

Conclusions:
Gradual increases in ECG changes were observed across BP groups. Even in this small cohort, we observed significantly more pathological ECG findings in the PHT group than in subjects with OBP. ECG is of utmost importance in risk stratification of subjects with PHT and helpful, simple and cheap tool in making decision how to treat PHT patient. ECG should be recorded in all subjects with PHT.
A COMPARISON OF EUROPEAN AND AMERICAN GUIDELINES TO GAUGE THE PREVALENCE OF HYPERTENSION IN 16–19 YEAR OLD BLOOD DONORS
Authors: Eason Stephen , Sayers Merlyn 
Published: June 2022

Objective:
Against the background of increasing risk for hypertension in adolescents, we decided to investigate blood donation as an opportunity to compare national guidelines for identification of individuals, between 16–19 years of age, meeting hypertension criteria.

Design and method:
16–19 year old volunteers donating blood between 2015 and 2020 were enrolled. They were asked to identify their ethnicity. Those declining were identified as “other’’. Blood pressure was measured using automated equipment (Welch Allyn, ProBP). We compared the European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines for hypertension (> = 140/90 mmHg) with the American College of Cardiology/American Heart Association (ACC/AHA) guidelines for hypertension (> = 130/80 mmHg).

Results:
There were 71912 participants, 63.2% (45441) and 36.8% (26471) were female and male respectively.

Conclusions:
More males, by comparison with females, met hypertension guideline criteria in all ethnicities. The prevalence of hypertension was highest in African Americans. Depending on which international hypertension criteria are chosen, there are significant differences in the size of population of 16–19 year olds identified for attention. Determining a suitable threshold that will justify investigation their investigation and treatment will require long term clinical trials.
INCIDENT AORTIC ROOT DILATATION IN THE GENERAL POPULATION: FINDINGS FROM THE PAMELA STUDY
Authors: Dell’Oro Raffaella , Cuspidi Cesare , Facchetti Rita , Vanoli Jennifer , Quarti-Trevano Fosca , Mancia Giuseppe , Grassi Guido 
Published: June 2022

Objective:
We sought to assess the long-term changes in aortic root (AR) diameter in a population-based sample, focusing on new onset AR dilatation, as well as on the demographic and clinical variables independently related to this dynamic process.

Design and method:
A total of 1,122 participants with measurable echocardiographic parameters at baseline and after a ten-year follow-up were included in the analysis. Sex-specific upper limits of normality for absolute AR diameter, AR diameter indexed to body surface area (BSA) and to height were derived from 712 healthy normotensive PAMELA participants.

Results:
Over the ten-year follow-up new AR dilatation occurred in 3.4% (AR/BSA),4.4% (AR/height) and 7.3% (absolute AR), respectively. No substantial relationship was observed between baseline office and ambulatory BP or their changes over time and incident AR/BSA and AR/height dilatation. Baseline AR diameter and left ventricular mass index (LVMI) emerged as important predictors of AR dilation, regardless of the diagnostic criteria used. This was also the case for the 10-year change in LVMI. The strength of association between non-hemodynamic variables and new onset AR dilatation was variable, depending on the definition of the aortic phenotype.

Conclusions:
The incidence of AR dilatation in a general middle-aged population is a relatively infrequent but not so rare event and scarcely influenced by both office and out-office BP. On the contrary, it is strongly related to LVMI (and its variations over time). From a clinical perspective, this underlines that LVH prevention and regression can reduce the risk of AR dilatation in the community.
HIGH BLOOD PRESSURE IN THE EMERGENCY DEPARTMENT. A TOOL FOR DETECTION OF HYPERTENSION? A FOLLOW-UP STUDY OF UNSELECTED PATIENTS ATTENDING AN EMERGENCY DEPARTMENT
Authors: Bentzel Sara , Ohman Ottilia , Abdulla Karzan , Manhem Karin , Mourtzinis Georgios 
Published: June 2022

Objective:
Hypertension is the most preventable cause of morbidity and mortality, but many individuals are not diagnosed and lack treatment control. High blood pressure (BP) in the emergency department (ED) is commonly observed but mostly used for short-term evaluation. We aimed to study the usefulness of high BP in the ED as a screening tool for undiagnosed hypertension.

Design and method:
We used the electronic medical record system to identify all patients that had attended the ED at a university hospital from 2018–01–01 to 2018–03–31 and from 2018-07-01 to 2018-09-30 with an obtained BP > = 160/100 mm Hg measured in the ED. We excluded patients with previously diagnosed hypertension and patients on any BP-lowering medication. All patients identified where contacted two years after attending the ED, by mail with a letter of consent and a questionnaire with the following question: 1. Have you measured your BP after your visit to the ED? 2. Have you been diagnosed with hypertension? 3. If yes – what kind of BP-medication has been prescribed?

Results:
5424 patients attended the ED during the 6-months-period. 2625 patients were excluded due to a BP < 160/100 mm Hg, 1365 patients were excluded because of present BP-lowering medication, 523 patients were excluded because no BP was recorded, and 638 patients were deceased. A total of 271 patients were identified as suitable for the study and asked to participate. 167 individuals (62%) agreed to participate in the study and responded the questionnaire. Mean age of participants were 63,8 years and 50,2% were women. 135 patients (81%) had measured their BP after the ED-visit (question 1), and 48 (36%) of those had been diagnosed with hypertension (question 2). 96% of patients diagnosed with hypertension were on BP-lowering medication and 28% were on 2 or more different BP-lowering agents.

Conclusions:
To follow-up BP > = 160/100 mm Hg after an ED-visit can reveal undiagnosed hypertension in one third of the patients. Given the amount of undiagnosed hypertension, an ED-measured BP might provide an important tool with potential to detect and start treatment of hypertension.
RELATIONSHIP BETWEEN CADMIUM EXPOSURE, TRIGLYCERIDE-GLUCOSE INDEX AND CAROTID ARTERY ATHEROSCLEROSIS
Authors: Kim Kwanghyun , Kim Dae Jung , Ha Kyoung Hwa , Kim Hyeon Chang 
Published: June 2022

Objective:
Cadmium exposure is suggested to be associated with cardiovascular and metabolic diseases. We investigated the association between cadmium and carotid artery atherosclerosis and the mediating effect of serum triglyceride and glucose level represented by triglyceride-glucose index (TyG index).

Design and method:
Among Cardiovascular and Metabolic disease Etiology Research Center (CMERC) Cohort participants, participants who received serum heavy metal screening tests were selected (N = 200). Patients with more than 3 standard deviation level of serum cadmium were excluded (N = 1). TyG index was calculated as formula: ln [{fasting blood glucose (mg/dL) × triglyceride (mg/dL)}/2]. Carotid artery ultrasonography was conducted to test carotid artery atherosclerosis. Carotid artery plaque was considered present if the thickness is greater by 50% or more than the surrounding intima-media thickness or if its size was 1.5 mm or more. We used linear regression to test the association between serum cadmium level and TyG index, and Poisson regression to test the association between serum cadmium level, TyG index and number of plaques. Mediation analyses was conducted to detect the mediating effect of TyG index.

Results:
Serum cadmium level was associated with TyG index (=0.155, p-value = 0.042). Both serum cadmium level(=0.753, p-value = 0.039) and TyG index(=1.049, p = 0.010) were associated with number of carotid artery plaques. Mediation analyses showed that TyG index significantly mediated the association between serum cadmium level and carotid artery plaque (direct effect: =0.733, p-value = 0.042; indirect effect: =0.165, p-value = 0.048).

Conclusions:
Cadmium exposure increases the risk of carotid artery atherosclerosis. The assocaition is mediated by disturbance in serum triglyceride and glucose level.