bluuebunny/crossref_metadata_2025_split huggingface dataset:
SYSTEMIC VASCULAR RESISTANCE AS A PREDICTOR OF ANTIHYPERTENSIVE EFFICIENCY OF RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS
Authors: Manukyan Musheg , Falkovskaya Alla , Mordovin Victor , Zyubanova Irina , Tsoy Ekaterina , Pekarskiy Stanislav , Ryabova Tamara , Khunkhinova Simzhit , Vtorushina Anastasia , Dorzhieva Irina 
Published: June 2022

Objective:
To identify predictors of the antihypertensive efficacy of renal denervation (RDN) in patients with resistant hypertension (RHTN) and type 2 diabetes mellitus (T2DM) based on the results of a 12-month follow-up.

Design and method:
The study included 56 patients with RHTN and T2DM (mean age 60.1 ± 7.9 years, 32 women, mean 24-hour (24-h) blood pressure (BP) (systolic/diastolic) 156.8 ± 15.2/82.2 ± 12.1 mm Hg, mean HbA1c 7.2 ± 1.5%). The prospective interventional study with RDN (NCT02667912 and NCT01499810 at ClinicalTrials.gov) enrolled all patients. Office BP and ABPM, calculation of systemic vascular resistance (SVR) assessment were performed at baseline and 12-months after RDN. Forty-one patients completed a 12-month follow-up.

Results:
RDN led to a significant reduction in systolic and diastolic 24-h BP (-10.6/-6.4 mm Hg, p = <0.001/<0.001). Depending on the degree of decrease in 24-h systolic BP, the patients were retrospectively divided into 2 groups: “responders’’ (persons with a decrease in 24-h SBP by 10 or more mmHg) and “non-responders’’ (with a lesser degree of decrease in 24-h SBP). The proportion of respondents to the intervention was 68.3%. Initially, the group of “responders’’ not differed from the group of “non-responders’’ by age, BP and HbA1c level. At the same time, responders had higher SVR indicators (2.22 ± 0.44 and 1.73 ± 0.28 dyn × s × cm-5, p = 0.001) than non-responders. A ROC analysis showed that the best cut-off value of the SVR is 19,7 dyn × s × cm-5 with 71% sensitivity and 85% specificity (AUC: 0.82; 95% CI: 0.68–0.95; p < 0.001).

Conclusions:
Estimation of the systemic vascular resistance allows predicting the antihypertensive efficacy of renal denervation in patients with resistant hypertension and type 2 diabetes mellitus after a year of intervention.
SHOULD ALL SECONDARY CAUSES OF HYPERTENSION BE SCREENED IN PATIENTS WITH RESISTANT ARTERIAL HYPERTENSION?
Authors: Kvapil Tomas , Vaclavik Jan , Kocianova Eva , Benesova Klara , Jarkovsky Jiri , Kamasova Monika , Taborsky Milos 
Published: June 2022

Objective:
Secondary hypertension often presents as treatment-resistant hypertension. Patients with resistant hypertension therefore undergo an extensive workup to identify a potential secondary cause. We aimed to analyze whether it is necessary to screen all patients presenting with resistant arterial hypertension for all secondary causes of hypertension.

Design and method:
We retrospectively analysed the hospital records of patients with resistant arterial hypertension, who underwent complete laboratory and imaging examinations to exclude the secondary etiology of arterial hypertension. Standard descriptive statistics were used for statistical evaluation.

Results:
Among the 432 patients with resistant hypertension, secondary etiology of hypertension was found in 135 (31.1%). The most frequent cause was primary aldosteronism in 85 cases (63% relatively), followed by renovascular hypertension (15.6%), renal parenchymal hypertension (14.8%) and hyperreninism (3.7%). Obstructive sleep apnoea has been found in 14.7% patients. Less common causes were hypercortisolism (1.5%), pheochromocytoma (0.7%) and adrenogenital syndrome (0.7%). All patients with the last three rare causes presented with specific clinical symptoms (i.e. patient with pheochromocytoma was admitted for paroxysmal hypertension, adrenogenital syndrome was diagnosed in female patient with secondary male sex characteristics, patients with hypercortisolism had typical cushingoid signs).

Conclusions:
Secondary etiology was much more frequent (31%) in our group of patients with resistant hypertension than in non-selected hypertensive population (5–15%). We suggest that first line testing only for primary hyperaldosteronism and renovascular hypertension would be sufficient for patients with resistant hypertension without clinical clues suggestive of another particular secondary cause of hypertension.
PREVALENCE OF APPARENT-TREATMENT RESISTANT HYPERTENSION IN PERITONEAL DIALYSIS PATIENTS ASSESSED WITH THE USE OF 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING
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:
The prevalence of apparent-treatment resistant hypertension (aTRH) among patients with predialysis chronic kidney disease is 2–3 times higher than in the general population. The aim of the present study was to investigate the prevalence of aTRH in end-stage kidney disease (ESKD) patients undergoing peritoneal dialysis (PD).

Design and method:
A total of 140 ESKD patients treated with PD in 4 centers of Northern Greece underwent 24-hour ambulatory blood pressure monitoring with the oscillometric device Mobil-O-Graph (IEM, Stolberg, Germany). aTRH was defined as 24-hour ambulatory blood pressure (BP) equal or higher than 130/80 mmHg, despite the use of at least 3 antihypertensive medications of different categories or controlled hypertension in patients treated with at least 4 antihypertensives. Loop diuretics that are commonly prescribed in PD patients for long-term preservation of residual kidney function are generally ineffective in lowering BP and were not considered as a separate antihypertensive drug category in our analysis. To explore the association of volume overload with the severity of hypertension, the body composition of study participants was analyzed via bioimpendence spectroscopy (BCM, Fresenius Medical Care, Germany).

Results:
Of the 140 PD patients enrolled in the study, 42 (30%) had aTRH, 45 (32.1%) had uncontrolled hypertension under treatment with < 3 BP-lowering medications and the remaining 53 patients (37.9%) were either normotensives or had controlled hypertension with < 3 antihypertensives. The prevalence of aTRH among drug-treated hypertensives was 32.5%. Overhydration > 2.5L with the use of bioimpendence spectroscopy was detected in 38.1% of patients with aTRH, in 15.6% of patients with uncontrolled hypertension and in 18.9% of normotensives or patients with controlled hypertension (P< 0.05).

Conclusions:
The present study showed that aTRH affects approximately 30% of ESKD patients undergoing PD. However, the prevalence of true-resistant hypertension in this high-risk population is probably lower, since 38.1% of patients with aTRH had subclinical volume overload detected with the method of bioimpendence spectroscopy.
THE INFLUENCE OF SHORT-TERM EXERCISE TRAINING ON ARTERIAL BLOOD PRESSURE AND QT DISPERSION IN PATIENCE AFTER SURGICAL AORTIC VALVE REPLACEMENT
Authors: Stoickov Viktor , Ilic Marina Deljanin , Stoickov Milena , Tasic Ivan , Stoickov Ivan , Kostic Svetlana , Marinkovic Dragan , Simonovic Dejan 
Published: June 2022

Objective:
The aim of this study was to establish the influence of short-term exercise training on arterial blood pressure and QT dispersion in patients after surgical aortic valve replacement (SAVR).

Design and method:
The study involved 103 patients after SAVR, in the sinus rhythm without AV blocks or branch blocks. Average age of patients was 60.8 years. Patients were randomly divided into the physical training group (training group: 85 patients) and control group (non-training group: 18 patients). Patients were similar as to age and baseline stress test duration. In all subjects clinical examination, standard ECG and exercise test on treadmill according to Bruce protocol were performed and after that training group patients were included in physical training program for three weeks. Training group patients were instructed to follow a training program using the bicycle ergometer (10 min, 2 times a day), gymnastic exercises and walking. The patients continued to take the same medicaments in same doses. From standard ECG corrected QT dispersion (QTdc) was calculated.

Results:
After three weeks, we have found significant reduction of QTdc from 79.1 ± 19.7 to 70.8 ± 20.4 ms; p < 0.02 in the training group. Also, in the training group, we have found significant reduction of heart rate from 78.6 ± 7.1 to 65.9 ± 6.1 beats/min (p < 0.001), of systolic blood pressure from 137.4 ± 13.1 to 127.7 ± 11.5 mmHg (p < 0.025), of diastolic blood pressure from 87.8 ± 8.9 to 84.2 ± 7.5 mmHg (p < 0.01) and of double product from 11996.7 ± 1162.4 to 10518.8 ± 794.3 beat/min x mmHg; p < 0.001. In contrast, the non-training group showed no significant changes.

Conclusions:
The study showed that short-term exercise training have favourable effects on arterial blood pressure and QT dispersion in patients after SAVR. Physical training led to the significant decrease of myocardial oxygen uptake at rest and probably decreased the possibility of arrhythmia events in patients after SAVR.
EVALUATION OF BLOOD PRESSURE CONTROL AND THE EFFECTIVENESS OF DIFFERENT ANTIHYPERTENSIVES BY MEANS OF THE STRESS TEST
Authors: Nuñez Urquiza Juan Pablo , Martí Araceli , Cervantes nez , Reza Ana Paula Sotelo 
Published: June 2022

Objective:
To evaluate different antihypertensive drug regimens for the control of BP according to selected variables of the exercise stress test during cardiac rehabilitation

Design and method:
Observational, longitudinal, retrospective study in 419 debutant or uncontrolled hypertensive patients, between 18–87 years, treated at ‘El Instituto del Corazón de Querétaro’, from January 2015-December 2021, to which a stress test was performed. The statistical analysis was performed using the statistical software SPSS, Version 28.0.1.0, the comparison of the means between groups was made using the one-way analysis of variance (ANOVA) test. Three variables were considered to evaluate the response to exercise in blood pressure; the blood pressor response to exercise (hypertensive > 10, 7 -10 as normal, 0–7 as flat and < 0 as hypotensive), BP index (>1.22 were taken as normal) and recovery of systolic blood pressure (normal < 0.95)

Results:
When analyzing 75.5% were men and 24.5% were women, under hypertensive treatment includes Beta blockers (BB), calcium channel blocker (CCBs), angiotensin-converting enzyme (ACE) inhibitors, Angiotensin receptor blockers (ARBs), Loop diuretics and mineralocorticoid receptor antagonist (MCRA).
There was no significant difference in the pressor response under any antihypertensive treatment in monotherapy, however a better response was found in the BP index to exercise. In patients with two or more antihypertensive drugs, it was found a better response to the combined treatment with ARBs + MCRA, in the three variables evaluated

Conclusions:
The exercise stress test may represent a unique tool to assess the effective protection potential of drugs against an important increase in SBP in patients with hypertension during physical activity. The study design elements proposed have the potential to establish exercise testing as a valid tool to assess the efficacy of antihypertensive treatments during stress conditions. Cardiac rehabilitation can significantly improve the parameters assessed in the stress test. It will be useful to compare these data with a short- and long-term stress test and thus evaluate the effectiveness of antihypertensive therapy.
CARDIOPULMONARY TEST PARAMETERS USEFUL FOR ADDRESSING PATIENTS WITH PECTUS EXCAVATUM TO PROMOTION OF PHYSICAL ACTIVITY
Authors: Pellegrino Alessio , Casatori Lorenzo , Messineo Antonio , Ghionzoli Marco , Facchini Flavio , Modesti Alessandra , Modesti Pietro Amedeo 
Published: June 2022

Objective:
Exercise training increases muscle VO2 by increasing O2 transport and O2 uptake positively affecting cardiac output. In subjects with pectus excavatum cardiac output increase during exercise might be limited by the conformation of the chest. In this condition, the psychological impact of the deformity can further reduce the propensity to physical activity, leading to a sedentary lifestyle. Surgery is the preferred choice in severe cases. However, many patients with milder deformities can benefit from exercise-based treatment. The choice of the therapeutic strategy is fundamental, but the functional parameters on which to base this choice are not yet well defined. Therefore, we investigated the relationships between habitual physical activity and functional physiological parameters obtained from the cardiopulmonary exercise test (exercise performance and stroke volume at peak exercise) in pectus excavatum.

Design and method:
A cohort of adolescents (15 with pectus excavatum and 15 age- and sex-matched healthy controls) underwent Cardiopulmonary Exercise Test to estimate exercise performance (VO2 max) and stroke volume at peak exercise (VO2/HR, O2 pulse). Habitual weekly physical activity, estimated with International Physical Activity Questionnaire – Short Form (IPAQ-SF), was expressed as METs h-1·week-1. Determinants of exercise performance and stroke volume at peak exercise were investigated in the whole group with multivariable linear regression analysis adjusted for sex, body mass index, forced expiratory volume in the first second, and presence of pectus excavatum.

Results:
When compared to healthy controls, subjects with pectus excavatum had lower VO2 max (37.2 ± 6.6 vs 45.4 ± 6.4 mL·kg-1·min-1, p < 0.05), and O2 pulse (12.1 ± 2.4 vs 16.2 ± 3.6 mL·min-1·bpm-1, p < 0.05). Importantly, physical activity level was a predictor of VO2 max (B = 0.085; 95% Cl 0.010 to 0.160) while it did not affect O2 pulse (B = 0.035; 95% Cl -0.004 to 0.074).

Conclusions:
Training programs should be encouraged to increase cardiopulmonary performance in subjects with pectus excavatum. A marked reduction in O2 pulse at peak exercise might be considered as a criteria to address a subject towards surgery.
COMPARING POST-EXERCISE HYPOTENSION AFTER A HIGH-INTENSITY INTERVAL TRAINING IN MATCHED YOUNGER AND OLDER ADULTS
Authors: Ketelhut Sascha , Möhle Martin , Gürlich Tina , Hottenrott Laura , Hottenrott Kuno 
Published: June 2022

Objective:
An acute reduction in blood pressure (BP) can be observed after a single bout of exercise. Termed postexercise hypotension (PEH), this phenomenon has been well documented in different populations after exercise of various intensities, durations, and modalities. Even though PEH has been documented in young and older adults, no previous studies have directly compared different age groups. The present study aimed to compare the PEH effect after high-intensity interval training (HIIT) in matched older and younger adults. Furthermore, within-session oxygen consumption was assessed and compared.

Design and method:
Forty-three participants were recruited for this study. All participants performed baseline examinations assessing body mass index (BMI), resting BP, and maximum oxygen consumption (VO2max). Thereafter, twelve younger (24.4 ± 3.1 years) and 12 older (49.5 ± 7.4 years) participants matched for BMI, BP, and VO2max-percentiles were selected for further analysis. All participants completed a HIIT protocol consisting of 4x 30-seconds exercise bouts interspersed by 3 minutes of active recovery. Both before and throughout the 45 minutes after the training, peripheral systolic (pSBP) and diastolic (pDBP) blood pressure, central systolic (cSBP) and diastolic (cDBP) blood pressure, pulse wave velocity (PWV), and heart rate (HR) were assessed. Throughout the HIIT, oxygen consumption was continuously monitored, and time spent above 75%, 85%, 95%, and 100% of VO2max was computed.

Results:
Both groups revealed significant (p < .001) reductions over time in pSBP, pDBP, cSBP, cDBP, PWV, and HR. No significant group x time effects could be detected for pSBP (p = .581), pDBP (p = .937), cSBP (p = .691), cDBP (p = .965), PWV (p = .233), and HR (p = .711). There were no significant differences in times spent at different percentages of VO2max (p = .643).

Conclusions:
If matched for BMI, resting BP, and VO2max-percentiles, older and younger adults experience similar PEH effects after HIIT. Furthermore, within-session oxygen consumption was similar in both groups revealing comparable exercise intensities during the protocol. According to the present results, age does not affect PEH after HIIT.
EFFORT PERCEPTION AND HEMODYNAMIC RESPONSES TO THE 3/7 VS. 3X9 METHODS IN HEART FAILURE AND IN CORONARY ARTERY DISEASE PATIENTS: A RANDOMIZED-CROSS-OVER STUDY
Authors: Gillet Alexis , Chaumont Martin , Lamotte Michel , Roussoulieres Ana , Dewachter Celine , Forton Kevin , Deboeck Gael , Van De Borne Philippe 
Published: June 2022

Objective:
Patient adherence to cardiac rehabilitation (CR) centers may be improved by shorter exercise time. The new ‘3/7-method’, which consists of 5 successive sets of exercise with an increasing number of repetitions (3 to 7) separated by brief inter-set rest intervals (15 s), has been proven to achieve a greater and faster strength gain in healthy subjects. Further characterization (i.e., Borg scale, blood pressure (BP) and heart rate (HR)) of the 3/7-method safety is needed before using it in CR in patients with reduced ejection fraction (HFrEF) and coronary artery disease (CAD).

Design and method:
Using a randomized and cross-over study design, we compared the variation of Borg scale, BP and HR in the ‘3/7-method’ vs ‘3X9 method’ (gold standard - .3 to 9 repetitions with a longer inter-set rest interval (1 min)) in 23 HFrEF (58 ± 9y-13% female) and 22 CAD patients (64 ± 10y-14% female). The strength training consisted in leg extension against a load of ~ 70% of 1 repetition maximal. Perceived exertion was assessed at the end of the last set by using the modified Borg Scale (0–10). HR and BP were assessed noninvasively beat by beat.

Results:
Baseline BP, HR and Borg scale at the end of exercise were similar within the two methods. HR was higher with the 3/7 method compared to the 3X9 method in the HFrEF (85 ± 11 vs. 83 ± 12 bpm,-p = 0.014) and CAD (90 ± 13 vs. 87 ± 14 bpm,-p = 0.03) patients. In the CAD patients, systolic BP increased more with the 3/7 method compared to the 3X9 method (143 ± 22 vs. 133 ± 20 mm Hg-(p < 0.001)).

Conclusions:
The 3/7 and 3X9 strength training protocols elicit similar effort perception in our patients. The 3/7 method increases slightly HR in both groups and induces minimal rise in systolic BP in CAD patients. Taken together, our study suggests that, compared to the 3x9 method, the new 3/7-method is well tolerated and time-saving, at the price of small and likely irrelevant HR and BP variations. These encouraging results warrants further investigation of the advantages (i.e, adherence, improve strength and exercise capacity) of the 3/7 method in CR.
WORK-BASED ISOMETRIC EXERCISES EFFECT ON BLOOD PRESSURE: THE EEFIT STUDY
Authors: Cohen Daniel D. , Aroca-Martinez Gustavo , Carreño-Robayo Javier , Chacon-Manosalva Maria A. , Lopez-Lopez Jose , Otero Johanna , Camacho-Lopez Paul , Herazo-Beltran Yaneth , Castañeda-Hernandez Alvaro , Lopez-Jaramillo Patricio 
Published: June 2022

Objective:
To evaluate the effect of two workplace isometric exercise interventions on blood pressure in hypertensive adults.

Design and method:
A randomized controlled multicenter clinical trial conducted in hypertensive (>130 mmHg systolic blood pressure (SBP)) 35 to 65 years old in work places in Colombia. Participants were assigned to either of two interventions: isometric handgrip dynamometer training at 30% of maximum strength (HGD) or wall squat (WS), or to a control group following standard recommendations. The interventions were performed at the participant’s workplace and consisted of 4 sets of 2 minutes of sustained isometric contraction with 2 minutes’ rest between sets, 3 times per week for 12 weeks. SBP and diastolic blood pressure (DBP) were measured using an automatic device (Omron) with a standardized protocol before and after the 12-week intervention.

Results:
Pre and post measurements were completed by 105 hypertensive participants: mean age of 45 years (SD 9.5), 63.8% of which were men. In the HGD group (n = 38) there were significant decreases in SBP [Pre: 141 mmHg (SD 7.8), Post: 127 mmHg (SD 9.1) (p < 0.001)], and in DBP [Pre: 87 mmHg (SD 5.8), Post: 82 mmHg (SD 9.5) (p < 0.001)]. There were also significant decreases in the WS-group (n = 35) in SBP [Pre: 139 mmHg (SD 7.5), Post: 126 mmHg (SD 12.4) (p < 0.001)], and in DBP [Pre: 86 mmHg (SD 5.2), Post 82 mmHg (SD 8.1) (p < 0.001)]. In the control group (n = 32), there were no significant changes in either in SBP [Pre: 140 mmHg (SD 8.4), Post: 137 mmHg (SD 12.9)], or DBP [Pre: 86 mmHg (SD 5.0), Post: 85 mmHg (SD 8.0) (p = 0.71)].

Conclusions:
Both workplace isometric training interventions resulted in significant and clinically relevant reductions in blood pressure in subjects with high blood pressure. The combination of effectiveness, modest time commitment (42 minutes per week) and ease with which the interventions can be implemented in the workplace setting makes them both attractive and practical options with minimal barriers for participation. Furthermore, WS can be performed without any equipment.
EFFECT OF ACUPUNCTURE ON ATRIAL FIBRILLATION STRATIFIED BY CHA2DS2-VASC SCORE-CROSSTALK BETWEEN CONVENTIONAL AND MODERN MEDICINE
Authors: Syun Hu Wei 
Published: June 2022

Objective:
This research aimed to make statements regarding the reduction in atrial fibrillation (AF) risk due to acupuncturE

Design and method:
The Kaplan-Meier method was performed to calculate cumulative incidence of outcomes for each group, and the log-rank test were performed to compare differences between groups.

Results:
In CHA2DS2-VASc scores of 0~1, 2~3, 4~5, and > 5, cases with acupuncture were all associated with decreased incidence of atrial fibrillation (aHR, 0.46 with 95% CI, 0.42–0.51; p-value, < 0.001 in the CHA2DS2-VASc scores of 0~1; aHR, 0.53 with 95% CI, 0.50–0.57; p-value, < 0.001 in the CHA2DS2-VASc scores of 2~3; aHR, 0.56 with 95% CI, 0.52–0.61; p-value, < 0.001 in the CHA2DS2-VASc scores of 4~5; and aHR, 0.64 with 95% CI, 0.55–0.74; p-value, < 0.001 in the CHA2DS2-VASc scores of > 5).

Conclusions:
Protective effect of acupuncture on AF in a relatively dose dependent manner was observed in this study.