bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomarkers associated with prevalent hypertension and higher blood pressure in a population-based cohort: a proteomic approach
Authors: Dieden A , Holm H , Melander O , Pareek M , Molvin J , Rastam L , Lindblad U , Daka B , Leosdottir M , Nilsson P M , Olsen M H , Gudmundsson P , Jujic A , Magnusson M 
Published: October 2022

Abstract

Background
Globally, hypertension represents an enormous health issue as it is a major, yet modifiable risk factor for developing cardiovascular disease. Recently, chitinase-3-like protein 1 (CHI3L1) was shown to be positively associated with the incidence of hypertension among prehypertensive subjects, and variants of CHI3L1 gene were associated with both CHI3L1-levels and hypertension.

Purpose
To explore associations between prevalent hypertension and blood pressure, and 92 proteins with involvement in inflammation and cardiovascular disease.

Methods
Plasma samples from 1713 individuals from a Swedish population-based cohort (mean age 67.3±6.0 years; 28.9% women) were analysed with a proximity extension assay panel, consisting of 92 proteins. Prior to all analyses, subjects with prevalent cardiovascular disease, defined as having a history of prevalent coronary or stroke event, were excluded (n=189). Univariate logistic regression models were carried out exploring associations between each of the 92 proteins and prevalent hypertension, defined as systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, or use of antihypertensive treatment (n=1168, 76.4%). Bonferroni-corrected significant associations between proteins and hypertension were further analysed using stepwise selection of covariates, namely age, body mass index, diabetes status, and cystatin C, in logistic regression models. Proteins with significant adjusted associations with prevalent hypertension were further analysed for associations with systolic and diastolic blood pressure individually in stepwise linear regression models. Complete data on all variables were available in 1527 subjects.

Results
Sixteen proteins were significantly associated with prevalent hypertension in univariate analyses. After adjustment, three proteins remained significantly associated with prevalent hypertension (i.e., CHI3L1, low-density lipoprotein receptor (LDL receptor) and tissue plasminogen activator (tPA); Table 1). In analyses of associations with systolic blood pressure, CHI3L1 and LDL receptor showed significant associations. In analyses of associations with diastolic blood pressure, CHI3L1, LDL receptor and tPA showed significant associations (Table 1).

Conclusions
Higher CHI3L1, tPA and LDL receptor levels were positively associated with prevalent hypertension after multivariable adjustment, among 1527 elderly subjects without established cardiovascular disease. Furthermore, higher CHI3L and LDL receptor levels were positively associated with mean systolic, as well as mean diastolic blood pressure in multivariable analyses.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Swedish Medical Research Council and The Swedish Heart and Lung Foundation
New definition of hypotension in patients with reflex syncope using 24-hour ambulatory blood pressure monitoring (SynABPM Study)
Authors: Rivasi G , Brignole M , Groppelli A , Soranna D , Zambon A , Sutton R , Kenny R A , Ungar A , Fedorowski A , Parati G 
Published: October 2022

Abstract

Background
Diagnostic criteria for ambulatory blood pressure monitoring (ABPM) in patients with suspected reflex syncope are lacking.

Purpose
We hypothesized that patients with reflex syncope have a higher prevalence of systolic blood pressure (SBP) drops on ABPM than control subjects and we aimed to define the SBP cut-off values that allow identification of patients with hypotensive susceptibility.

Methods
We compared ABPM data from reflex syncope patients and controls, matched by average 24-hour SBP, age, sex and hypertension. Patients with constitutional hypotension, orthostatic hypotension, predominant cardioinhibition or competing causes of syncope were excluded. Daytime and night-time SBP drops (&lt;110, 100, 90, 80 mmHg) were assessed. Findings were validated in an independent sample.

Results
In the Derivation cohort, daytime SBP drops were significantly more common in 158 syncope patients than 329 controls. One or more daytime drop &lt;90 mmHg provided the best diagnostic yield (91% specificity, 32% sensitivity, Odds Ratio [OR]=4.6, p=0.001). Two or more-daytime drops &lt;100 mmHg achieved 84% specificity and 40% sensitivity (OR=3.5, p=0.001). Results were confirmed in the Validation cohort: one or more daytime SBP drop &lt;90 mmHg provided 94% specificity and 29% sensitivity (OR=6.2, p&lt;0.001), while two or more daytime SBP drops &lt;100 mmHg achieved 83% specificity and 35% sensitivity (OR=2.6, p&lt;0.001) (Figure 1).

Conclusion
SBP drops during ABPM are more common in reflex syncope patients than in controls. Cut-off values that may be applied in clinical practice are defined. This study expands the current indications for ABPM to patients with reflex syncope.

Funding Acknowledgement
Type of funding sources: None.
Additional opportunities for antihypertensive therapy improvement in young patients with arterial hypertension and concomitant obesity
Authors: Chernyshova K , Yakimenko O , Bondar V , Chernyshova H , Kolomiets S , Oliynyk D , Tbileli V , Maznichenko I E 
Published: October 2022

Abstract

The high prevalence of arterial hypertension (AH) and concomitant obesity in young patients is not only a medical but also a social problem. It is important to develop additional modern approaches to the management of young patients with AH and obesity, which will increase the effectiveness of existing antihypertensive (anti-AH) medical therapy and prevent early damage of target organs and complications.
The purpose of the research was to evaluate the antihypertensive efficacy of the proposed complex treatment and its impact on quality of life in young patients with AH and obesity (or overweight).

Material and methods
123 patients with AH (ESC 2018), of young age 18–44 (mean age 32.81±0.58) y.o. were examined, among them the overweight was in 40 patients, obesity - in 42 patients. The average BMI was (28.34±0.45) kg/m2. All patients were divided into 2 groups depending on the treatment: Group 1 – standard anti-AH treatment, Group 2 – modified combined therapy, which included on the background of standard anti-AH medications the dosed controlled physical exercises with its obligatory registration, a modified DASH diet with increased intake of Ca-containing products and Metformin in the presence of insulin resistance according to the HOMA index (with correction of dose depending on BMI). In dynamics the patients were performed daily blood pressure monitoring (BPM) was performed and the SF-36 questionnaire was used to assess the quality of life (QOL).

Results and discussion
According to BPM data in the Group 1 the average 24-hour value of SBP decreased by 12.5% (p=0.01), in Group 2 – by 20.2% (p=0.001), DBP - by 11.2% (p=0.03) and by 18.8% (p=0.01) respectively (the difference between the groups for SBP and DBP was p=0.032 and p=0.041, respectively). Assessing the degree of nocturnal blood pressure decreasing, in the Group 1 the percentage of patients with insufficient nocturnal blood pressure decreasing (non-dipper) and stable increasing (night peaker) decreased non-significantly (p=0.086), unlike the Group 2, where there was a significant (p=0.02) positive dynamics in relation to these unfavorable types of blood pressure profile. Evaluating the indicators of QOL according to SF-36, the physical component of health in the Group 1 increased by 16.7%, in Group 2 – by 33.4% (p=0.001), the mental component of health – by 13.5% and 28.9%, respectively (p=0.001).
Thus, the additional use of the proposed treatment complex with the inclusion of dosed registered exercises, increased consumption of Ca-containing products and correction of insulinresistance significantly increases the effectiveness of antihypertensive medical therapy and has a positive effect on physical and mental components of QOL in young patients with AH and obesity or overweight.

Funding Acknowledgement
Type of funding sources: None.
Differentiated approach to the treatment of uncomplicated hypertensive crisis
Authors: Sadulloeva M , Khamidullaeva G A , Ataniyazov K H H , Ibragimova I A , Yuldasheva A D 
Published: October 2022

Abstract

Background
In primary health care, especially in rural areas, non-standard treatment of hypertensive crises is still used. In the present research study, we wanted to implement proven standards for uncomplicated hypertensive crisis management based on baseline blood pressure.

Purpose
To explore the clinical and hemodynamic efficiency of urapidil and captopril for the purpose of a differentiated approach to the treatment of uncomplicated hypertensive crisis.

Methods
The research includes 132 patients with a diagnosis of “Uncomplicated hypertensive crisis” in an average age All patients underwent physical examination, ECG, ECHOKG, ultrasound examination of the brachiocephalic arteries, biochemical analyzes, determination of microalbuminuria to exclude acute damages of organs and systems on account of HCR. All investigations were carried out within 10–15 minutes after the initial address of patients, according to the recommendations of the European Society of Hypertension/European Society of Cardiology (ESH/ESC 2018). Office blood pressure (BP) was measured on admission, 15, 30, 60 and 120 minutes after taking the antihypertensive drug

Results
The antihypertensive efficacy of urapidil and captopril in uncomplicated hypertensive crisis was assessed by the dynamics of average BP, a decrease in ABP by 10% at the first 30 minutes and by 20–25% within 120 minutes was considered as a positive antihypertensive effect. In the urapidil's group (n=104), BP before treatment corresponded to the 3rd grade of arterial hypertension (AH): 202.33±22.06/105.3±7.82 mm Hg. Urapidil at an average dose of 44.6 mg significantly reduced the BP by −27.27±4.7% by 120 minutes. In the captopril's group (n=28), BP also corresponded to the 3rd grade of AH (192.5±23.76/103.53±6.85 mm Hg), whereas systolic BP was significantly lower than systolic BP in the urapidil's group. Despite this, captopril at an average dose of 33.2 mg did not show a sufficient decrease of average BP by the 120 minutes, and an intergroup significant difference in the degree of decrease in BP was revealed: −16.94±5.25% in the captopril group versus −27.27±4.7% in the urapidil group, p&lt;0.005. But captopril showed sufficient antihypertensive efficacy in 7 patients with 2nd grade of AH (172.71±8.08/101.85±1.8 mm Hg), reducing the BP by −21.19±3.03%.

Conclusion
A differentiated approach to the reduction of uncomplicated hypertensive crisis with urapidil and captopril showed a high clinical and hemodynamic efficacy of urapidil in patients with the 3rd grade of arterial hypertension. The effectiveness of captopril was limited in patients with the 3rd grade of hypertension, while in patients with the 2nd grade of hypertension, captopril showed a significantly clinical and hemodynamic effects.

Funding Acknowledgement
Type of funding sources: None.
Blockade of the renin-angiotensin system as a therapeutic target of NAFLD: results of an experimental model of hypercholesterolemia
Authors: Soares Sturzeneker M C , Precoma D B , De Noronha L , Oliveira P G M , Viechineski F N , Koscianski A M , Dlugosz A C , Karas B , Calixto C M , Hessman J H , Busnello L A 
Published: October 2022

Abstract

Background/Introduction
Non-alcoholic fatty liver disease (NAFLD) is often associated with metabolic syndrome (MS) and its components, including systemic arterial hypertension (SAH). In a recently published meta-analysis, the estimated prevalence of SAH in patients with NAFLD was 39.34%. Recently published observational studies have shown that the presence of NAFLD is independently associated with an increased risk of identifying SAH. Therefore, we can infer that we will often have to treat SAH in patients with NAFLD and that potential beneficial effects of the antihypertensive drug, in this context, may influence the choice of the respective drug.

Purpose
To evaluate the effects of olmesartan in an animal model of NAFLD (hypercholesterolemic rabbits).

Methods
34 rabbits divided into 3 groups: control group (CG) n=13, olmesartan group (OG) n=12 and normal control group (NCG) n=9. The NCG received standard chow for laboratory rabbits, the CG and OG received standard chow plus 1% cholesterol. The OG was medicated with olmesartan 1 mg/kg/day throughout the study period (8 weeks), and the three groups were euthanised in the eighth week. Serum levels of glucose, total cholesterol, triglycerides, creatinine, aspartate aminotransferase (AST) and alanine aminotransferase were evaluated at baseline and euthanasia, and liver tissue samples were taken in the euthanasia from the three groups. Haematoxylin-eosin stained slides were analysed based on the histological scoring system for NAFLD, Gomori,s trichrome stained slides were used for further evaluation of fibrosis, and immunostained slides with antibodies anti-nitric oxide synthase inducible (iNOS) for hepatic oxidative stress analysis.

Results
The steatosis (p=0.013), lobular inflammation (p&lt;0.001), ballooning (p=0.039), and fibrosis (p=0.015) scores were significantly lower in the OG compared to the CG. Similarly, NAFLD activity scores were significantly lower in OG compared to CG. The hepatic expression of iNOS was significantly lower in OG than CG (P=0.001). The serum variables results suggest no direct effect of olmesartan in any of them.

Conclusion(s)
Olmesartan significantly attenuated hepatic oxidative stress, the development of steatosis, lobular inflammation, ballooning, fibrosis and steatohepatitis. Therefore, it suggests that olmesartan may be considered a potentially suitable option for hypertensive patients with NAFLD.

Funding Acknowledgement
Type of funding sources: None.
Comparative effect of 3 different fix-combination antihypertensive treatments in fasting glucose, fasting insulin, OGTT and HbA1c levels, in prediabetic hypertensive patients
Authors: Liontos A , Biros D , Papathanasiou A , Papagiannopoulos C , Klouras E , Veliani C , Kolios N G , Pappa C , Liberopoulos E , Elisaf M , Milionis H , Liamis G 
Published: October 2022

Abstract

Introduction
The effect of various antihypertensive drugs on the glucose homeostasis has been discussed extensively. Dual combination treatment is advised with current guidelines. We present comparative data of the effect of delapril/manidipine versus valsartan/amlodipine versus telmisartan/amlodipine combination treatments, in fasting glucose, fasting insulin, OGTT and HbA1c levels, before and after the 3-month treatment, in hypertensive prediabetic patients.

Methods
Data were collected from 154 patients from the outpatient clinic for patients with lipid disorders, hypertension and diabetes of our hospital, during the period 2014–2018. A number of 53 persons was randomized in the delapril/manidipine group 30/10 mg per day while 51 persons had been randomized in the group of telmisartan/amlodipine 80/5mg per day and 54 patients in the valsartan/amlodipine 160/5 mg per day. All patients successfully completed the study. Baseline characteristics are presented in Table 1A.

Results
The resulting alternations in glucose, insulin, OGTT and HbA1c levels, before and after the 3-month treatment are presented on Table 1B for the 3 groups of treatment.

Conclusions
In the comparison between the groups, a statistically significant difference was found in the change in INS values from the beginning of treatment until 3 months, for the TEL/AMLO treatment group, where a statistically significant difference from the DEL/MANI treatment group (p-value&lt;0.01) and a strong statistically significant difference from the VAL/AMLO treatment group (p-value&lt;0.001) were noted. The TEL/AMLO group had the only decrease in insulin levels compared to the other treatment groups where an increase was observed, after the treatment. The change in OGTT levels showed a statistically significant difference (p-value&lt;0.05) between the DEL/MANI treatment group (a decrease of 6.63%) compared to the TEL/AMLO treatment group (an increase of 1.53%) after 3 months of treatment.

Funding Acknowledgement
Type of funding sources: None.
Device and non-device-guided slow breathing to reduce blood pressure in hypertensive patients: a systematic review and meta-analysis
Authors: De Freitas Goncalves K S , Queiroz Godoy Daniel A C , Tatagiba Lamas J L , Ceretta Oliveira H , De Campos Pereira Silveira R C , Cloutier L , Velludo Veiga E 
Published: October 2022

Abstract

Backgroud
Hypertension (HTN) is a multifactorial chronic disease. Considering the high prevalence rates of this disease, treatment of HTN is necessary, not only to reduce BP levels, but also to prevent the development of cardiovascular, cerebrovascular and kidney diseases. This treatment can be medication and/or non-farmacological, like device-guided slow breathing (DGSB) or non-device-guided slow breathing (NDGSB).

Purpose
The aim of this systematic review and meta-analysis is to summarize the effects of DGSB and NDGSB on blood pressure levels of patients with hypertension.

Methods
This study is systematic review and meta-analysis of randomized clinical trials, about hypertensive patients, with or without comorbidity, over 18 years old, of both sexes, with or without hypertensive medication. The selected studies showed comparisons between groups that performed DGSB and/or NDGSB with control conditions. The primary outcome was the value of systolic blood pressure (SBP) and diastolic blood pressure (DBP) after the interventions.

Results
Twenty-two studies involving 17,214 participants were included in the quantitative analysis. Considerable heterogeneity was revealed between studies. Using random effect model, it was found that DGSB did not significantly reduce SBP and DBP compared to usual care, both in terms BP values and in relation to their variations (SBP, MD −2.13 mmHg, [95% CI −12.71 to 8.44], 288 individuals; I2=93%, high heterogenity: DBP, MD −0.90, 95% CI −3.97 to 2.11, 288 individuals; I2=63%, substantial heterogenity. SBP variations MD −2.42, 95% CI −7.24 to 2.40, 443 individuals; I2=85% high heterogenity/DBP variations MD −1.67, 95% CI −4.57 to 1.24, 443 individuals; I2=80%, high heterogenity).

Conclusion
Based on these results it appears that DGSB did not reduce blood pressure in hypertensive patients and NDGSB is a new path for future.

Funding Acknowledgement
Type of funding sources: None.
Blood pressure alterations in recently COVID-19 vaccinated patients
Authors: Sanidas E , Papadopoulos D , Anastasiou T , Velliou M , Michalaki E , Fotsali A , Golemati S , Mantzourani M , Barbetseas J 
Published: October 2022

Abstract

Background
A non-immediate hypertensive response short after COVID-19 vaccination has been reported. Mild to moderate elevated arterial blood pressure (BP) levels have been documented few days after a single or two-doses vaccine. This study sought to investigate this observation as a potential side effect in patients with known hypertension and healthy controls.

Methods
A total of 100 vaccinated patients between the age of 50 to 70 years old were studied. They were randomly assigned to one of the approved and available vaccines (Pfizer, Astra Zeneca, Moderna, Johnson & Johnson). Half of them were hypertensives under medical treatment and half of them were not. All participants had systolic BP &lt;140mmHg and diastolic BP &lt;90mmHg before vaccination and volunteered for standard daily home BP measurements (HBPM) and ambulatory BP measurements (ABPM) between the 1st and the 21st day after considered fully COVID-19 vaccinated.

Results
All patients, hypertensives or not, had at some point a recorded hypertensive response for both systolic (SBP) and diastolic (DBP) BP after considered fully vaccinated. Hypertensives were older and with higher body mass index (BMI). Some of the hypertensive patients received additional medication whereas some of the non-hypertensive patients started life modification changes and systematic BP measurements for a possible diagnosis of hypertension.

Conclusions
Vaccination for COVID-19 seems to be related with a short period of hypertensive response. This phenomenon was partial and mostly observed in older overweight hypertensives.

Funding Acknowledgement
Type of funding sources: None.
Prescriptive appropriateness in primary cardiovascular prevention: data from our hospital
Authors: Maloberti A , Ceruti D , Gualini E , Colombo V , Giani V , Milani M , Sun J , Alloni M , Giannattasio C 
Published: October 2022

Abstract

Background
The main cause of waste of health resources is represented by overuse of diagnostic and therapeutic procedures. Given its high prevalence and the importance of identifying hypertensive-mediated organ damage, management of patients with arterial hypertension can lead to a lack of appropriateness. The aim of this study was to evaluate the prescriptive appropriateness of non-invasive diagnostic tests (Echocardiography, Carotid ultrasound, ECG exercise testing, 24h Ambulatory blood pressure monitoring) in outpatients referring to an ambulatory of primary cardiovascular prevention.

Methods
559 specialistic ambulatory visits were retrospectively analysed and appropriateness of every prescription was evaluated. An integration of different Italian and European guidelines was used to define appropriateness. Moreover, we evaluated the correlation between prescriptions, appropriateness and clinical characteristics of the population.

Results
During the 559 ambulatory visits analysed, 449 prescriptions were made, including 198 echocardiographies, 148 carotid ultrasound, 85 24h ABPM and 18 ECG exercise testing. The global percentage of appropriate prescriptions was 40.3%. Focusing on each test, appropriateness rate was 49.4% in 24h ABPM, 43.9% in echocardiography, 38.9% in ECG exercise testing and 30.4% in carotid ultrasound. A significant correlation was identified between the age and cardiovascular risk category of patients and the appropriateness of echocardiography, 24h ABPM and carotid ultrasound, and a correlation between appropriateness of echocardiography and the duration of hypertension and the presence of valvular heart disease.

Conclusions
Our study shows a relevant percentage of inappropriate prescriptions of non-invasive cardiologic exams; moreover, there might be a greater lack of appropriateness in young and low risk patients.

Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Niguarda Hospital, Milan, Italy