bluuebunny/crossref_metadata_2025_split huggingface dataset:
HYPERTENSION OUTCOMES OF ADRENALECTOMY FOR UNILATERAL PRIMARY ALDOSTERONISM
Authors: Václavík Jan , Hartmann Igor , Hruska Frantisek , Kocianová Eva , Frysak Zdenek , Nesvadbova Marika , Tudos Zbynek , Ctvrtlik Filip , Benesova Klara 
Published: June 2022

Objective:
To evaluate laboratory and clinical results after unilateral adrenalectomy in patients with primary aldosteronism (PHA).

Design and method:
A cross-sectional analysis was performed using data from patients who underwent transperitoneal laparoscopic adrenalectomy for PHA, between January 2008 and December 2019. Surgical indications were based on adrenal venous sampling without ACTH stimulation. Analyses included patient demographics; preoperative clinical, pharmacological, laboratory, and radiological data; and postoperative results assessed after a median of 4 months. Antihypertensive drug use was quantified by estimating the daily defined dose (DDD) of antihypertensive medication, thus enabling standardized comparison of dosage between the drug classes. Statistical assessments included univariable and multivariable logistic regression analysis.

Results:
This study enrolled 87 patients. The patients were taking 5.4 DDD of antihypertensive medication before surgery, and 3.0 DDD after surgery. Complete biochemical success of surgery was reached 67 patients (77%), 19 patients (22%) had partial biochemical success. Complete clinical success with normalization of blood pressure and withdrawal of all antihypertensive drugs was achieved in 19 patients (22%). 57 patients (65%) exhibited a reduction of DDD after surgery and/or improvement of blood pressure - partial clinical success. Thus, in 76 (87%) of all enrolled patients, surgery had an overall positive effect on hypertension control. Multivariable logistic regression showed that complete clinical success was independently associated with female gender and baseline sum of antihypertensive drugs DDD < 4.

Conclusions:
A majority of patients undergoing unilateral adrenalectomy for PHA achieved markedly improved hypertension control, despite almost halving their antihypertensive medication. Almost a quarter of patients were cured and able to cease using all antihypertensive drugs.
AMBULATORY BLOOD PRESSURE IN POSTMENOPAUSAL WOMEN ON ESTROGEN, ANDROGEN OR PROGESTERONE THERAPY
Authors: Stojanovic Milos , Vujovic Svetlana , Ivovic Miomira , Gajic Milina Tancic , Marina Ljilja , Miletic Marija , Nedeljkovic Biljana Beleslin , Stojkovic Mirjana , Ciric Jasmina , Zarkovic Milos 
Published: June 2022

Objective:
Objective of this study was to evaluate different hormone replacement therapy (HRT) combinations on ambulatory blood pressure (ABPM) and body mass index (BMI) in postmenopausal women.

Design and method:
One hundred and fifty women 47–62 y’s of age were first on estrogen/androgen therapy, then they were without HRT therapy for three months and later on estradiol and drospirenone combined therapy. Validated, Meditech ABPM 05 was used to obtain 24-h blood pressure (BP) after each regime. All women did not change antihypertensive treatment during the study. Wilcoxon Signed Rank Test was used to examine whether there was a statistically significant difference in blood pressure and body mass index values at different hormone therapy regimens.

Results:
There were no significant differences in BP parameters and BMI between different therapy regimes but lowest BP and BMI values were recorded while women were on estradiol and drospirenone combined therapy. The affinity of progesterone for the mineralocorticoid receptor is about five times that of aldosterone and may well antagonize the salt-retaining effect of estrogens, and thus lowering of blood pressure.

Conclusions:
We may conclude that estradiol and drospirenone combined therapy lowers blood pressure and maintains a stable body weight in postmenopausal women.
IMPROVEMENT OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION AFTER TREATMENT FOR PRIMARY ALDOSTERONISM CORRELATES WITH REVERSAL OF RENIN SUPPRESSION
Authors: Puar Troy , Cheong Chin Kai , Foo Roger , Saffari Ehsan , Tu Tianming , Lee Sheldon , Chai Siang Chew 
Published: June 2022

Objective:
Primary aldosteronism (PA) leads to hypertension, left ventricular hypertrophy and systolic dysfunction. While treatment can lead to regression of left ventricular mass, improvement of left ventricular function has not been demonstrated, using the conventional left ventricular ejection fraction for assessment. We used speckle-tracking echocardiography to assess if treatment of PA can improve left ventricular subclinical systolic dysfunction.

Design and method:
We prospectively recruited 57 patients with PA. All patients underwent 24–hours ambulatory blood pressure (BP) measurements and 2D echocardiography, including global longitudinal strain (GLS), at baseline and 12 months after surgical or medical therapy.

Results:
Forty–eight of 57 patients underwent adrenal vein sampling, and all procedures were successful. Twenty–five patients underwent unilateral adrenalectomy, and 32 patients were treated with medications. Patients treated with surgery had improved daytime systolic and diastolic BP, with reduced antihypertensive medications, while patients on medications had improved daytime systolic BP, with increased medications. While left ventricular ejection fraction did not change in either group post-treatment, GLS improved post–adrenalectomy by –2.3, 95%CI: –3.9 to –0.6, P = 0.0095, and post–medications by –1.3, 95%CI: –2.6 to 0.03, P = 0.089. On multivariate analysis, baseline GLS was associated with baseline diastolic BP (P = 0.019). Post–adrenalectomy, there were also improvements in left ventricular mass index by –10, 95% CI: –18.0 to –2.4, P = 0.012 left atrial volume index by –5.0, 95%CI: –9.1 to –2.2, P = 0.0016 and mitral E/e’ –1.9, 95%CI: –4.1 to –0.5, P = 0.0064, which were not significant in patients treated medically. Improvement in GLS was independently correlated with baseline GLS (P = 0.0001), and increase in plasma renin activity (P = 0.0068).

Conclusions:
Treatment of hyperaldosteronism can effectively reverse left ventricular systolic dysfunction, with greater benefit seen with surgery compared to medications. Greater improvement of systolic function is associated with increase in renin levels. This underlies the importance of adequate treatment to reverse the sodium overload state, that is the hallmark of PA.
SIMULTANEOUS ADRENAL VEIN SAMPLING WITH SUBSEQUENT SEQUENTIAL SECOND LEFT SAMPLING: A NEW PERSPECTIVE IN PRIMARY ALDOSTERONISM
Authors: Gebara Nicole , Eid Roland , Pagny Jean-Yves , Cornu Erika , Baron Stephanie , Riancho Julien , Martiano Mikael , Pariente Benjamin , Laffy Pierre-Yves , Carreres Thierry , Ahmar Marc Al , Azizi Michel , Amar Laurence 
Published: June 2022

Objective:
Adrenal venous sampling (AVS) is a technically challenging procedure that has its limitations because of a potentially unestimated risk of tube inversion between right (RAVS) and left (LAVS) adrenal venous sampling, which can lead to operating the wrong side in patients with lateralized PA.
The aim of this study is to evaluate whether a subsequent sequential second left adrenal venous sampling (LAVS2) can ensure a higher success rate of the procedure and limit the risk of tube inversion in patients who underwent a simultaneous AVS.

Design and method:
This an observational retrospective study conducted at the Hypertension Unit at Georges-Pompidou European Hospital in Paris, France, that analyzes patients who underwent an AVS between first June 2015 and end of May 2021. The difference between all three AVS was tested using Mann-Whitney test.
A random sampling of 100 patients was distributed to 6 physicians, 2 times in a 5-day interval, to test whether they can identify LAVS1 and RAVS based on LAVS2 and to compare between categories: lateralized versus non-lateralized PA, experts versus not experts physicians, at day 1 and day 5.

Results:
Among the 408 patients, the median age was 46 years. Lateralized PA was found in 216 patients (52.9%). (LAVS2-LAVS1) was inferior to (LAVS2-RAVS) in 90.4% of the cases and significant in all groups (table). In lateralized PA, all expert physicians gave the correct answer in 100% of the cases at day 1. The clinical expertise and PA lateralization were significantly associated with answers. In the correct answers’ category, there was no effect of time on the correct answer but statistically significant effects of clinical expertise and PA lateralization (p < 0.001).

Conclusions:
The use of a LAVS2 limits the risk on misinterpretation of AVS due to error in the labeling of the sample. As this procedure is easy and cost effective, it could be used in all the centers who do perform AVS. Therefore, based on the HEGP experience, we describe a roadmap for an AVS protocol to ensure a successful procedure
MTOR INHIBITOR IMPROVES TESTOSTERONE-INDUCED MYOCARDIAL HYPERTROPHY IN HYPERTENSIVE RATS
Authors: Chen Jianshu , Yu Jing 
Published: June 2022

Objective:
Compelling evidence have described the incidence of hypertension and left ventricular hypertrophy (LVH) in postmenopausal women is significantly increased worldwide. Our team’s previous research identified that androgen was an underlying factor contributing to increased blood pressure and LVH in postmenopausal women. However, little is known about how androgens affect LVH in postmenopausal hypertensive women. The purpose of this study was to evaluate the role of mTOR signaling pathway in myocardial hypertrophy in androgen-induced postmenopausal hypertension and whether mTOR inhibitors can protect the myocardium from androgen-induced interference to prevent and treat cardiac hypertrophy.

Design and method:
For that, ovariectomized (OVX) spontaneously hypertensive rats (SHR) aged 12 weeks were used to study the effects of testosterone (T 2.85 mg/kg/weekly im) on blood pressure and myocardial tissue. On the basis of antihypertensive therapy (chlorthalidone 8 mg/kg/day ig), the improvement of blood pressure and myocardial hypertrophy in rats treated with different dose gradients of rapamycin (0.8 mg/kg/day Vs 1.5 mg/kg/day Vs 2 mg/kg/day ip) in OVX+ estrogens (E 9.6 mg/Kg/day, ig)+T group was further evaluated.

Results:
After T intervention, the OVX female rats exhibited significant increments in the heart weight / tibial length (TL), cross-sectional area of cardiomyocytes and the mRNA expressions of atrial natriuretic peptide, B- myosin heavy chain and matrix metalloproteinase 9 accompanied by a significant reduction in the uterine weight/TL and issue inhibitor of metalloproteinase 1. Mammalian rapamycin receptor (mTOR), ribosomal protein S6 kinase (S6K1), 4E-bindiong protein 1(4EBP1) and eukaryotic translation initiation factor 4E in myocardial tissue of OVX+E+T group were expressed at higher levels than those of the other four groups. On the other hand, rapamycin abolished the effects of T-induced cardiac hypertrophy, decreased the systolic and diastolic blood pressure of SHR, and inhibited the activation of mTOR/ S6K1/4EBP1 signaling pathway in a concentration-dependent manner.

Conclusions:
Collectively, these data suggest that the mTOR/S6K1/4EBP1 pathway is an important therapeutic target for the prevention of LVH in postmenopausal hypertensive women with high T levels. Our findings also support the standpoint that the mTOR inhibitor, rapamycin, can eliminate T-induced cardiomyocyte hypertrophy.
COMPREHENSIVE BIOMARKER PROFILING OF HYPERTENSION IN 36,985 FINNISH INDIVIDUALS
Authors: Palmu Joonatan , Tikkanen Emmi , Havulinna Aki S. , Vartiainen Erkki , Lundqvist Annamari , Ruuskanen Matti O. , Perola Markus , Ala-Korpela Mika , Jousilahti Pekka , Würtz Peter , Salomaa Veikko , Lahti Leo , Niiranen Teemu 
Published: June 2022

Objective:
Previous studies on the association between metabolic biomarkers and hypertension have been limited by small sample sizes, low number of studied biomarkers, and cross-sectional study design. In the largest study to date, we assess the cross-sectional and longitudinal associations between high-abundance serum biomarkers and blood pressure (BP).

Design and method:
We studied cross-sectional (N = 36,985; age 50.5 ± 14.2; 53.1% women) and longitudinal (N = 4,197; age 49.4 ± 11.8, 55.3% women) population samples of Finnish individuals. We included 53 serum biomarkers and other detailed lipoprotein subclass measures in our analyses. We studied the associations between serum biomarkers and BP using both conventional statistical methods and a machine learning algorithm (gradient boosting) while adjusting for clinical risk factors.

Results:
Fifty-one of 53 serum biomarkers were cross- sectionally related to BP (adjusted P < 0.05 for all). Conventional linear regression modeling demonstrated that LDL cholesterol, remnant cholesterol, apolipoprotein B, and acetate were positively, and HDL particle size was negatively, associated with SBP change over time (adjusted P < 0.05 for all). Adding serum biomarkers (cross-sectional root-mean-square error: 16.27 mmHg; longitudinal: 17.61 mmHg) in the model with clinical measures (cross- sectional: 16.70 mmHg; longitudinal 18.52 mmHg) improved the machine learning model fit. Glucose, albumin, triglycerides in LDL, glycerol, VLDL particle size, and acetoacetate had the highest importance scores in models related to current or future BP (Figure).

Conclusions:
Our results suggest that serum lipids, and particularly LDL-derived and VLDL-derived cholesterol measures, and glucose metabolism abnormalities are associated with hypertension onset. Use of serum metabolite determination could improve identification of individuals at high risk of developing hypertension.
ASSOCIATION BETWEEN PSYCHOLOGICAL DISTRESS AND LATER REPORTS OF HYPERTENSION AMONG ADULTS IN EAST ZIMBABWE
Authors: Shamsuddin Shehla , Davis Katherine , Moorhouse Louisa , Mandizvidza Phyllis , Dadirai Tawanda , Nyamukapa Constance , Gregson Simon , Chigogora Sungano 
Published: June 2022

Objective:
Little is known about the temporal relationship between psychological distress (PD) and hypertension, especially in low-income countries. We assessed the association between PD and later development of hypertension among Zimbabwean adults, and the role of smoking, alcohol consumption and recreational drug use in this relationship.

Design and method:
Data were taken from the Manicaland Study, an open cohort study in east Zimbabwe. Participants aged 15–54 were surveyed in 2012/2013 and followed-up in 2018/19. At baseline, PD was assessed using the Shona Symptom Questionnaire, a screening tool developed and validated in Shona-speaking countries. Participants self-reported whether they were currently: smokers; took drugs for pleasure; or regularly visited bars and/or consumed over three alcoholic drinks per sitting. At baseline and follow-up, participants reported whether they had ever been diagnosed with hypertension by a doctor/nurse. We selected individuals who did not report hypertension at baseline and used logistic regression to examine associations between baseline PD and hypertension at follow-up, controlling for sociodemographic and economic confounders. We also explored the effect of including binary variables capturing smoking status, drug use and alcohol consumption in the model.

Results:
742 participants who completed baseline and follow-up surveys, were not hypertensive at baseline, and had full covariate data, were included. At baseline, 10.4% of these had PD, and at follow-up 17.5% (overall) had developed hypertension. The odds of developing hypertension were 2.01 (95% Confidence Interval = 1.14–3.54) times higher among those with PD at baseline, after adjustment for sociodemographic and economic confounders (Table 1). Introducing smoking status, drug use and alcohol consumption into the model had little effect on our findings (adjusted Odds Ratio, aOR:2.04, 1.16–3.59) and we had little evidence that these behaviours were independently associated with hypertension (aORs:smoking:1.41, 0.40–4.98; alcohol consumption:1.49, 0.61–3.66; drug use:0.49, 0.14–1.75).

Conclusions:
PD was associated with increased odds of developing hypertension in Manicaland. However, we did not find strong evidence that smoking status, drug use and alcohol consumption contributed to this relationship, which may reflect the low prevalence of these behaviours in our study. The results suggest mental health interventions may be beneficial for reducing hypertension in Zimbabwe.
A COMBINATION OF HYPERTENSION AND A HIGH ATHEROGENIC INDEX OF PLASMA AS AN INDICATOR OF A CORONARY HEART DISEASE RISK
Authors: Ruf Ruslan , Grinshtein Yuri , Shabalin Vladimir 
Published: June 2022

Objective:
Our study demonstrated the changes in the prevalence of coronary heart disease (CHD) depending on hypertension and atherogenic index of plasma

Design and method:
The atherogenic index of plasma (AIP) is a common logarithm of a ratio of triglycerides and HDL-cholesterol molar concentrations. According to M. Dobiasova (2006), at AIP < 0.10, cardiovascular risk is low; at the range of 0.10 to 0.24, the risk is medium, and if AIP is higher than 0.24, the risk is high.
For the randomized sample of the ESSE-RF study, which included 1603 Krasnoyarsk Krai inhabitants, we used a standard questionnaire, anthropometry, office blood pressure measurement, and biochemical blood analyses to find a prevalence of known cardiovascular diseases and their risk factors. We registered hypertension if a person took antihypertensive medications or their measured blood pressure was at 140/90 mm Hg or higher.
Coronary heart disease was diagnosed with a Rose angina questionnaire and 12-lead rest ECG encoded by the Minnesota system (the authors wish to thank the National Medical Research Center for Therapy and Preventive Medicine for assistance in laboratory tests and ECG encoding).

Results:
In 14.7% (95% CI = 13.8%-15.6%) of the study participants, we found CHD. Along with it, 73.5% of people had a low risk by AIP; in 10.4%, AIP indicated a medium risk, and 16.1% of the study participants had a high risk.
People with normal blood pressure had no significant interrelation between the prevalence of CHD and AIP level (p = 0.669). Contrary, hypertensives with low risk by AIP had 23.2% (95% CI = 19.5%-27.0%) cases of CHD; at the medium risk, the prevalence of CHD was at 31.5% (95% CI = 21.8%-41.1%), and in the group of high risk, there were 17.5% (95% CI = 11.9%-23.1%) people with CHD. Chi-square was for trend at p = 0.036.

Conclusions:
The atherogenic index of plasma and coronary heart disease had no interrelation in normal blood pressure. In hypertension, however, the atherogenic index of plasma at a medium level may indicate a higher probability of coronary heart disease.
A NOVEL VASOACTIVE PENTAPEPTIDE “PG1’’ FROM BUFFALO ICE-CREAM PROTECTS FROM ANGIOTENSIN-EVOKED HIGH BLOOD PRESSURE
Authors: Carrizzo Albino , Pietro Paola Di , Basilicata Manuela , Pepe Giacomo , Damato Antonio , Campiglia Pietro , Vecchione Carmine 
Published: June 2022

Objective:
Arterial hypertension is the most important risk factor for cardiovascular diseases, myocardial infarction, heart failure, renal failure and peripheral vascular disease. In the last decade, milk-derived bioactive peptides have attracted attention for their beneficial cardiovascular properties. Identify new vasoactive natural peptides able to fight arterial hypertension that can be used as a preventive strategy.

Design and method:
Here we combined in-vitro chemical assay such as LC-MS / MS analysis of buffalo ice cream, ex-vivo vascular studies evaluating endothelial and smooth muscle responses using pressure myograph, and translational assay testing in-vivo the vascular actions of PG1 administration in murine models.

Results:
We demonstrate that a novel buffalo ice-cream-derived pentapeptide “QKEPM’’, namely PG1, is a stable peptide that can be obtained at higher concentration after gastro-intestinal digestions (GID) of buffalo ice-cream (BIC). It owns potent vascular effect in counteract the effects of angiotensin II-evoked vasoconstriction and high blood pressure levels. Its effects are mediated by the inhibitory effect on AT1 receptor leading to a downregulation of p-ERK½ / Rac1-GTP and consequent reduction of oxidative stress.

Conclusions:
These results strongly candidate PG1, as a novel bioactive peptide for the prevention and management of hypertension, thus expanding the armamentarium of preventive strategies aimed at reducing the incidence and progression of hypertension and its related cardiovascular complicications.
COHORT STUDY IN PATIENTS WITH HYPERTENSIVE CRISIS: CHARACTERISTICS AND FOLLOW-UP AFTER 30 DAYS
Authors: Flórido Carime Farah , Pierin Angela Maria Geraldo 
Published: June 2022

Objective:
Characterize patients with hypertensive crisis and evaluate occurrences 30 days after the hypertensive event.

Design and method:
Cohort study was performed with 583 patients treated between August 2020 and July 2021, from an Emergency Unit in a Hospital specializes in cardiology in São Paulo, Brazil. Inclusion criteria: 18 years old, systolic pressure > 180 mmHg and/or diastolic pressure > 120 mmHg, have telephone contact. A consulting on the electronic medical record was made to identify the elegible patients, whom after were included on the REDCap platform, and 30 days of the hypertensive event, an interview by telephone was made to investigate cardiovascular events.

Results:
The sample characteristics were: women (53%), 66.24(13.89) years, white ethnicity (78.7%), married (50.5%), high school (27.9%), retired people (77.5%), average [(mean(SD)] monthly income R$2384.6 (R$3438). The mean(SD) systolic/diastolic blood pressure, respectively, in emergency department was 189.74(17.46)/99.28(19.89) mmHg. Hypertensive emergencies were 63.8%, urgencies 27.4% and 8.7% were not possible to classify. The prevalent symptoms in the emergency department were: chest pain (41.2%), dyspnea (34.3%), nausea (11.7%), dizziness (10,4%), radiating pain (10.1%). The most used treatments were: anticoagulant (35.1%), diuretic (28.1%), analgesic (25.3%), ACE inhibitor (23.8.7%). Regarding the performance of tests: 85.6% underwent laboratory tests, 71% electrocardiogram, 36.3% echocardiogram and 30.5% computed tomography. After being treated at the emergency department, 60.1% of patients were discharged, 35.8% hospitalized, 3.8% transferred to other hospitals and 0,3% died. Regarding comorbidities, 97.7% had hypertension, 68.7% high cholesterol, 48.4% diabetes, 34.1% acute myocardial infarction, 25.1% heart failure, 19.6% kidney disease and 12% stroke. Regarding outcomes 30 days after the hypertensive event, 1.4% had some type of stroke, being 85.7% ischemic and 14.3% hemorrhagic, 2.3% had acute infarction of the myocardium, and 2% cardiorespiratory arrest. Also, 14.5% returned to a health service for high blood pressure, and 23.1% for others reasons like angina, bradycardia, aortic aneurysm, covid-19, acute pulmonary edema, epigastric pain, dyspnea. Besides we identify that 4.7% died within 30 days.

Conclusions:
The findings indicate the need for tertiary systematization, through outpatient follow-up programs for people with hypertensive crisis in emergencies units.