bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL CHARACTERISTICS OF PATIENTS WITH FIBROMUSCULAR DYSPLASIA ASSOCIATED WITH ANEURYSMS (ARCADIA-POL STUDY)
Authors: Talarowska Paulina , Januszewicz Magdalena , Jozwik-Plebanek Katarzyna , Dobrowolski Piotr , Prejbisz Aleksander , Florczak Elzbieta , Gasecki Dariusz , Zylkowski Jaroslaw , Michalowska Ilona , Kabat Marek , Persu Alexandre , Januszewicz Andrzej 
Published: June 2022

Objective:
To assess the prevalence and distribution of aneurysms among patients with fibromuscular dysplasia (FMD) and to compare clinical characteristics of FMD patients with and without aneurysms.

Design and method:
Out of 435 patients enrolled into ongoing ARCADIA-POL study FMD was confirmed in 281 cases. A standardized FMD data form was used for data collection. All patients underwent detailed clinical evaluation including ABPM, biochemical evaluation, biobanking and imaging, duplex Doppler of carotid and abdominal arteries and whole body angio-CT.

Results:
Among 281 patients with FMD enrolled into study the presence of at least one aneurysm was documented in 92 patients. Mean age was 52,3 ± 12,0 years. Most of patients were women (91.3%). Hypertension was found in 81.4% and hyperlipidemia in 51.2% patients. Almost one third (27.3%) of subjects were active smokers during time of admission. History of use of contraceptive pills was reported by 20.7% women. Among patients with aneurysms FMD lesions were classified as multifocal in 89.1% patients. Single-site FMD was observed in 66.3% patients. The most frequent localization of FMD lesions were renal, cervical and intracranial arteries. In almost half of patients (45.7%) with FMD and aneurysm the presence of two or more aneurysms was confirmed, giving the total number of 124 aneurysms. Aneurysms were most frequently documented in renal arteries (14.6%), intracranial arteries (11.7%), splenic artery (10.7%) and cervical arteries (3.9%). Among 70 patients with newly diagnosed aneurysms 72.9% subjects were qualified for interventional treatment. Two out of 92 patients with FMD and aneurysm presented severe complications caused by ruptured aneurysm. FMD patients with aneurysms as compared to those without aneurysms were more often female, were older, had more often history of contraceptive use and hyperlipidemia. There were no significant differences in other clinical parameters between analysed groups.

Conclusions:
Among FMD patients we confirmed high prevalence of aneurysms (32.7%). This supports the concept that FMD is generalized arteriopathy and all patients should be systematically evaluated and if needed qualified for interventional treatment.
EFFECT OF RENAL DENERVATION ON CARDIO ANKLE VASCULAR INDEX IN SUBJECTS WITH RESISTANT HYPERTENSION
Authors: Postadzhiyan Arman , Tochev Sotir , Andreeva Lora , Rifai Nizar , Finkov Bojidar 
Published: June 2022

Objective:
The aim of the study was to determine the clinical characteristics of patients with increased arterial stiffness (AS) undergoing renal sympathetic denervation (RSD) and to examine the role of CAVI measurement as a surrogate for AS in predicting the outcome of RSD.

Design and method:
Consecutive patients with resistant hypertension who underwent RSD workout at the University Hospital Saint Anna, Sofia, ESH Excellence center of hypertension, between January 2014 and December 2020 were included. RSD was performed on the grounds of resistant hypertension defined as mean daytime systolic BP = > 135 mmHg or diastolic BP = > 85 mmHg in 24-hr ambulatory blood pressure measurement (ABPM) despite the intake of at least three antihypertensive agents, including a diuretic. CAVI was measured using the VaSera system (Fukuda Denshi Co, Japan). RSD was performed with the Symplicity Flex catheter (Medtronic, Minneapolis, MN, USA) according to a standardized protocol.

Results:
The study included 62 patients with treatment-resistant hypertension, after out of office blood pressure measurement and intensification of therapy, renal denervation was performed in 32 (51.6%). Patients with increased arterial stiffness, defined as CAVI> median of 8.3, were older, with a larger waist circumference and previous cardiovascular events. A long-term effect of the RSD, reported as a reduction in 24-hour systolic blood pressure above 10 mmHg at month 12, was found in 22 patients (68.8%). The median of the observed reduction of the 24-hour systolic blood pressure was -16 mmHg at 95% confidence interval -9.1 to -21 mmHg. Despite similar baseline out-of-office and office blood pressure and concomitant antihypertensive therapy, patients with lower arterial stiffness had a more significant blood pressure effect of renal denervation, a result that persisted within 12 months of follow-up. In contrast, the effect of the procedure was clinically insignificant among patients with baseline CAVI values above 8.3.

Conclusions:
These findings hold the promise that AS might be used as a selection criterion for RSD, thereby improving outcome following RSD.
PATIENT PREFERENCES FOR PHARMACEUTICAL AND INTERVENTIONAL HYPERTENSION TREATMENTS: RESULTS FROM A DISCRETE CHOICE EXPERIMENT
Authors: Pathak Atul , Weber Michael , Poulos Christine , Coulter Joshua , Cohen Sidney , Debruin Vanessa , Jones Denise , Kandzari David 
Published: June 2022

Objective:
To quantify patient benefit-risk preferences for interventional and pharmaceutical treatments for hypertension (HTN) using discrete choice experiment (DCE) methods.

Design and method:
A DCE is an established survey method commonly used to quantify preference for selected treatment attributes in hypothetical profiles, allowing estimation of tradeoffs that are acceptable when evaluating several attributes together. Respondents with physician confirmed uncontrolled HTN were presented with a series of questions with hypothetical HTN treatments with differing levels of treatment risk and benefit. Respondents could also choose no HTN treatment. A random parameters logit analysis of the survey treatment choices was used to estimate the relative preferences and importance for each attribute.

Results:
400 patients completed the survey, with 52% female, mean age 59 ± 13 years, systolic blood pressure (BP) 155 ± 12 mmHg and 1.8 ± 0.9 average prescribed antihypertensive medications. Reduction in office systolic blood pressure (BP) was the most influential treatment attribute. The remaining attributes were less impactful on respondents’ treatment choice (i.e., duration of effect, whether treatment was interventional, number of daily pills, risk of vascular injury, risk of medication side effects, and risk of temporary pain and bruising). When given a choice between no HTN treatment and an interventional treatment with a 20% risk of procedure side effects, the likelihood of selecting the interventional treatment increased with the magnitude of blood pressure reduction. No more than a 2.5 mmHg reduction in office systolic BP was sufficient to offset treatment risks associated with an interventional procedure like RDN.

Conclusions:
Among U.S. patients with HTN, a DCE study demonstrated that BP reduction was the most important driver of choice, risks were less important, and a minimal BP reduction was sufficient to offset treatment risks associated with an interventional procedure like RDN.
ACUTE POST-DYNAMIC, ISOMETRIC AND COMBINED RESISTANCE EXERCISE HYPOTENSION IN PATIENTS WITH HYPERTENSION: A RANDOMIZED STUDY
Authors: Forjaz Claudia Lucia De Moraes , Oliveira-Silva Laura G , Silva-Junior Natan D. , Pio-Abreu Andrea , Silva Giovanio V. , Drager Luciano L. , Sousa Julio S. , Fecchio Rafael Y. 
Published: June 2022

Objective:
American guidelines included dynamic resistance exercise (DRE) and isometric handgrip (IH) in hypertension treatment. A single session of DRE decreases blood pressure (BP) during the recovery period, which has been described as post-exercise hypotension (PEH). However, the occurrence of PEH after a session of IH is controversial and the post-exercise effects of the association of DRE and IH, in a combined resistance exercise (CRE), has not been evaluated. Thus, this study investigated the effects of DRE, IH and CRE on post-exercise BP and its hemodynamic, autonomic and vascular mechanisms.

Design and method:
Seventy medicated hypertensive men (52 ± 8 years) were randomly allocated to perform 1 of 4 interventions: DRE (8 exercises, 3 sets, 50%1RM, repetitions until moderate fatigue), IH (4 sets, 2 min-unilateral contraction, 30% MVC), CRE (DRE + IH) and control (CO - seated resting). Office BP, systemic hemodynamics (CO2 rebreathing technique), cardiovascular autonomic modulation [spectral analysis of heart rate (HR) and BP variabilities] and brachial vascular parameters (ultrasound) were evaluated before and after the interventions. Thus, the responses to interventions (post – pre-intervention values) were calculated and compared among the groups by ANOVAs with significance level set at P < 0.05.

Results:
Responses to IH were similar to CO, showing that a single session of IH did not promote PEH, and did not affect any of the BP mechanisms. On the other hand, DRE and CRE induced responses significantly different from IH and CO. DRE and CRE significantly decreased systolic BP, diastolic BP, mean BP, stroke volume and cardiac baroreflex sensitivity, while they significantly increased HR, brachial artery diameter, blood flow and vascular conductance during the post-exercise period. Additionally, DRE significantly decreased post-exercise cardiac vagal modulation (HFR-R, nu) and increased cardiac sympathovagal balance (LF/HF).

Conclusions:
DRE, but not IH, elicits PEH, which is accompanied by vasodilation and increased HR, via a higher sympathovagal balance and lower baroreflex sensitivity. The addition of IH to DRE, in a CRE, does not potentiate PEH and did not change its mechanisms.
AGE AS A RISK FACTOR FOR CARDIOVASCULAR EVENTS IN PATIENTS WITH HYPERTENSIVE CRISES AFTER 12-MONTH FOLLOW-UP: A GREEK REGISTRY
Authors: Fragkoulis Christos , Polyzos Dimitrios , Mavroudis Andreas , Dimitriadis Kyriakos , Kariori Maria , Leontsinis Ioannis , Andrikou Ioannis , Kakouri Niki , Kouremeti Maria , Grigoriou Kalliopi , Thomopoulos Costas , Konstantinidis Dimitrios , Tsioufis Konstantinos 
Published: June 2022

Objective:
Few data have been published regarding the long-term prognosis of patients with hypertensive crises (HC). The aim of our study was to record the prevalence and clinical phenotype of patients with hypertensive urgencies (HU) and emergencies (HE) assessed in the emergency department (ED) and during ospitalisation and a 12-month follow-up to record new events in a Greek tertiary hospital.

Design and method:
The registry population consisted of patients admitted to the ED with acute increase in blood pressure (BP) (systolic BP> or = 180mmHg and/or diastolic BP > or = 120mmHg) and depending on the presence or absence of acute hypertension-mediated target organ damage they were divided into the HE and the HU group, respectively. In all patients the demographic and clinical parameters were recorded for 12 months and there was a 12-month follow-up for new end points.

Results:
Out of 38,589 patients assessed in the ED during a period of 12 months, 353(0.91%) had HC, out of whom 256(72.5%) had HU and 97(27.5%) had HE. The mean age of all patients was 67.4 ± 12.9 years, 49% were males and 80% had a history of hypertension. During the study period 81 patients were excluded for not completing the follow-up. We stratified the total population of HC by age separating patients into two groups, e.g. > or = 65 and < 65 years old, and ospital the composite end point consisting of deaths or ospitalisations caused by cardiovascular disease. Patients > or = 65years old presented more composite events (36 vs 8 events, p = 0.019, HR for patients > or = 65years 2.68, 95% CI 1.18–6.12). Cox regression models were adjusted for age, gender, cardiovascular disease, chronic kidney disease and diabetes mellitus.

Conclusions:
Our study implies that age > or = 65years is an independent risk factor for deaths or ospitalisations caused by cardiovascular disease in patients with HC. There is an arising necessity for more intensive follow-up of these patients and the need for further research in this setting.
PATIENT PERSPECTIVES ON TREATMENT ADHERENCE IN HYPERTENSION: PRELIMINARY RESULTS OF AN ESH SURVEY IN FIVE COUNTRIES
Authors: Burnier Michel , Persu Alexandre , Azizi Michel , Prejbisz Aleksander , Cunha Vitoria , Gupta Pankaj , Vaclavik Jan , Versmissen Jorie , Kreutz Reinhold , Kjeldsen Sverre E. 
Published: June 2022

Objective:
The ESH Working group on Lifestyle, Cardiovascular Therapy and Adherence, in partnership with Servier, has developed a web-based questionnaire in different languages to investigate patients’ perspectives on hypertension and treatment adherence. The objective of this survey was to decipher patients’ perception, motivations and barriers to drug treatment adherence in hypertension.

Design and method:
Eligible participants were men and women aged > 18 years, living in France, Germany, Italy, Spain and UK, with a diagnosis of hypertension made by a physician and internet access. Data were collected through patients’ websites and organizations from January to March 2022.

Results:
We included 595 participants (329 women, 55.3%, mean age 65 y); 72% were hypertensive for > 5 years, 93% were treated with antihypertensive medications for > 3 months and 50% had uncontrolled (140/90 mmHg) office BP at 3 months. The median number of all medications taken every day was 4 of which 2 were antihypertensive drugs. On a 10-point Likert scale, participants reported a modest impact of hypertension on their quality of life (3) or social and family life (3.1). The median level of stress was 5.2. In 76.6% of participants home BP was measured several times weekly (25%) or monthly (31%) or more. Antihypertensive medications were stopped unintentionally by 40% or taken irregularly by 44% of patients. The reasons for non-adherence to medications were forgetfulness (45%), side effects (17%) and running out of medications (15%). In 50% of cases, patients do not inform their physicians when stopping medications. The most useful approaches to support adherence reported by participants were single-pill combinations and smaller and cheaper pills. Information on hypertension and its treatment were considered sufficient for 33% of patients.

Conclusions:
In patients with internet access and willing to participate, our survey shows that despite having an uncontrolled office 3 month BP in 50% of them, participants report: 1) a modest impact of hypertension on their quality of life and a moderate level of anxiety, 2) frequent and usually non intentional non-adherence to prescribed antihypertensive medications, and 3) the necessity to improve the information provided to them.
AMBULATORY BLOOD PRESSURE MEASUREMENT AS A PREDICTOR OF HYPERTENSION MEDIATED TARGET ORGAN DAMAGE IN VERY ELDERLY POPULATION: THE MAPACHESS STUDY
Authors: Sanchez Marcos Sanchez , Qin Jiwei Chen , Viñas-Esmel Esther , Mas Miriam Costafreda , Torres Manuel , Ferre Rosa Martinez , Benitez Cristina , Benito Cristina Sierra , Payeras Antonio Coca , Babkowski Miguel Camafort 
Published: June 2022

Objective:
International guidelines recommend Ambulatory Blood Pressure Monitoring (ABPM) in the diagnosis and follow-up of hypertensive patients based on the superior reliability prognostic value compared to office BP. Our objective was to analyze the relationship between ABPM control and target organ damage (TOD) in the elderly population.

Design and method:
Observational, retrospective, longitudinal study of a cohort of treated hypertensive patients older than 75 years. A baseline ABPM was obtained in all patients and was repeated after 6 months follow-up. Clinical data on associated CVRF, TOD, cardiovascular events, and emergency room visits were collected at baseline and 6 months of follow-up.

Results:
A total of 39 consecutive patients were included, 38.5% women, mean age 80 years (75–89), 30% diabetic, 50% obese and 58% dyslipidemic. Previous stroke was observed in 5.6% patients and 9% had a previous acute myocardial infarction (AMI). The mean in-treatment office BP was 142 (± 22) / 71 (± 14) mm Hg and 30.8% were controlled (BP < 140/90 mmHg). The mean in-treatment 24-hour BP was 141 (± 15) / 70 (± 11) mm Hg. New CV events were observed in 19.7 during follow-up. When we compared the characteristics between the group with good ABPM (defined as mean 24 h BP < 130/80 mm Hg) and the group with poor control, only left ventricular mass index (LVMI) was significantly higher in the latter (170 g/m2 (poor control) vs. 128 g/m2 (good control); Anova p 0.044).

Conclusions:
In treated elderly hypertensive patients, poor BP control by 24h-ABPM is significantly correlated with a greater degree of LVH. Considering the retrospective design of this pilot study in a very limited number of patients, these findings need to be confirmed in larger studies.
PILATES METHOD IMPROVES PHYSICAL CAPACITY AND ANTI-OXIDATIVE SYSTEM IN ELDERLY WOMEN
Authors: Lacchini Silvia , De Oliveira Patrick Rodrigues , Alves Tatiana Pereira , Da Silva Dias Danielle , Busse Alexandre Leopold , De Angelis Katia , Filho Wilson Jacob 
Published: June 2022

Objective:
The decline in physical capacity in humans occurs as a consequence of ageing. It is well established that oxidative mechanisms play a role in ageing process, leading to oxidative accumulation in tissue damage. Regular physical exercise can minimize the physiological changes that occur during aging and also contribute to improving the individual’s health and well-being. The aim of the present study is to verify the effects of resistance physical training on oxidative damage and physical capacity in elderly women who practice Pilates (P) or Strength Training (ST).

Design and method:
Elderly volunteer were evaluated and divided into P (68 ± 4 years age) or ST (66 ± 3 years age) groups (n = 20 per group), according to individual choice for the modality. The training protocol (moderate intensity) lasted 12 weeks, with 2 sessions of 60 minutes per week. All volunteers underwent dual-energy x-ray absorptiometry (DXA) and handgrip strength (HGS) for physical and functional assessment. Blood sample was collected for the analysis of oxidative stress markers (TBARS, Carbonilated proteins, NOX and SOD activities and Frap).

Results:
The results show that resistance exercises in P and ST modalities are effective in inducing changes in physical composition (body weight, fat percentage and bone density did not change). On the other hand, ST was effective in reducing fat mass in upper and lower limbs and increasing HGS (+40%), while P increased lean mass in limbs and trunk. Pilates method was more efficient in increasing muscle mass throughout the body, while strength training was more efficient in allowing fat loss. Finally, Pilates method was effective in increasing SOD activity (+20%), reducing protein oxidation (17%). On the other hand, strength training implemented an increase in the antioxidant system at the end of the ROS production cascade, which seems not to have been effective in reducing lipid oxidation (Frap increased 37%, while TBARS and NOX maintained 50% and 30% higher compared to Pilates, respectively).

Conclusions:
The results allow us to conclude that Pilates method, for a period of 12 weeks, is effective in bringing anti-oxidative capacity and in the quality of life of sedentary elderly women.
SERUM AND IONIZED MAGNESIUM IN ELDERLY HYPERTENSIVES
Authors: Kisters Klaus Kisters , Sophia Kisters , Uwe Gröber 
Published: June 2022

Objective:
Magnesium is involved in about 600 enzymatic and metabolic reactions. In patients at risk, e.g. elderly, a magnesium deficiency has to be taken into account. This can result in a variety of diseases, e.g. cardiovascular disorder and hypertension.
Diagnosis can be made by laboratory, anamnesis (drugs) or clinical symptoms. Especially elderly (up to 30 %) or hypertensives are risk patients for a magnesium deficiency. In these patients a magnesium supplementation is then often of benefit.

Design and method:
In our study 45 elderly hypertensives with normal renal function were investigated (serum creatinine was 1.1+/-0.1 mg/dL). All patients were older than 60 years. None of our patients took magnesium supplements. All patients had an essential hypertension grade 1 and 2 according to ESH guidelines classification. Anti-hypertensive treatment was performed using usual drugs (e.g. betablockers, calcium antagonists or Renin-Angiotensin-Aldosterone System (RAAS) blockers), no diuretics for at least 4 weeks before start of the study.
Serum magnesium concentrations were measured by a Cobas Apparatus, Roche, Germany. The analysis of the measurements of ionized magnesium concentrations was carried out with a Prime Plus system from NOVA Medical Devices Corp., Rödermark, Germany. This is a point-of-care unit device with a high precision standard. The tests use either capillary blood or about 1 mL of whole blood and the complete measurement process takes about only 1 minute.

Results:
In serum magnesium content only 1 patient was below normal range of 1.7 md/dl. Mean+/- s.d. was 1.96+/- 0.16 mg/dl. In contrast in 12 of 45 patients ionized magnesium was significantly below the normal range (27%, 0.54+/-0.06 mmol/l). There was no correlation between serum or ionized magnesium concentrations (n.s., Pearson’ s or Spesrmann rank test, p value 0.91 and 0.41). Bood pressure was controlled.

Conclusions:
In conclusion normal serum magnesium values do not exclude a magnesium deficiency in elderly hypertensive patients. The determination of ionized magnesium might be a better tool in this context. A magnesium deficiency is often observed in elderly and has to be substituted in a sufficient amount to avoid cardiovascular and other diseases.
THE CHANGE IN QUALITY OF LIFE IN DRUG TREATED HYPERTENSIVE PATIENTS AFTER 10 YEARS OF ANTIHYPERTENSIVE TREATMENT
Authors: Kantola Ilkka M. , Kantola Taru 
Published: June 2022

Objective:
To study the change in quality of life in Finnish drug-treated hypertensive patients after ten years of antihypertensive treatment.

Design and method:
In the beginning the patients participated in a six-month study where their antihypertensive treatment was titrated either by using home or 24 hour ambulatory measurement. Thereafter they have been in the ordinary out-patient care.
SF-36 questionnaire was filled out by 44 patients (23 females and 21 males, aged 66.1 (6.1), 55–77 years) in the beginning and after 10.6 (2.9) (6–13) years of antihypertensive treatment. All of them used at least one antihypertensive agent.

Results:
The mean (SD) SF-36 questionnaire scores after about 10 years of antihypertensive treatment were (maximum 100): Physical functioning 78.5 (19.9), role-physical 72.6 (34.0), bodily pain 68.1 (22.2), general health 64.5 (16.2), vitality 68.6 (15.8), social functioning 90.1 (19.0), role-emotional 76.0 (35.9), mental health 84.5 (14.4) and general health 3.2 (0.7). Compared to the same age Americans social functioning and mental health were higher (better) in our treated hypertensive patients.
During 10 years of antihypertensive treatment physical functioning decreased significantly 4.8 (14.4) (p = 0.039). Instead, vitality 6.3 (18.6) (p = 0.032), social functioning 6.1 (17.5) (p = 0.028) and mental health 4.5 (11.7) (p = 0.030) increased significantly. Other parameters did not change significantly.

Conclusions:
According to our results physical functioning decreased and vitality, social functioning and mental health increased during 10 years of antihypertensive treatment. The decrease in physical functioning is probably explained by aging, because physical function decreases in normal population about 0.5/life year. Perhaps, good antihypertensive treatment explains the increase in those three mental parameters. Thus, it seems that according to the SF 36 questionnaire quality of life in Finnish treated hypertensive patients is quite good and do not decrease significantly during ageing.