BP Values Research Articles

Assessment of serum lipoprotein (a) and total cholesterol in children of CAD parents

: More and more Indians are falling prey to coronary artery (CAD) which is one of the genetic diseases attributed to numerous gene-environment interactions. There are various reasons for this including a sedentary lifestyle, genetic predisposition, pollution, smoking, drinking, a fatty diet and a general ignorance about what causes heart ailments. In India, 10% of the present infant mortality may be accounted for by CAD. This study was conducted to take appropriate measurements in the children of parents with diagnosed of CAD who are at high risk in relationship to serum Lp (a) and total cholesterol. Two groups 50 each of both sexes between 5-18 years children were compared for the risk factors of CAD and data was analysed statistically by using student’s t test and Pearson correlation coefficient analysis. : It shows that Group A had increased values of serum Lp (a) and total cholesterol (p<0.001) than Group B. Diastolic BP values were also significantly higher in Group A children. In addition, Lp (a) level was directly corelated with total cholesterol levels (r=0.734; p<0.001). : The familial environment pay a very important role for the severity of CAD in childhood and children of CAD parents should be screened regularly. It also serves as an important diagnostic marker of CAD in youth at early stage.

Low Birth Weight and Related Metabolic Risk Factors, Cardio-Respiratory Fitness and Physical Activity in Adolescents

Background/Objectives: The associations between low birth weight (LBW) and the aggregation of metabolic risk factors (MRF) in youth remain ambiguous. Thus, this study analysed the interrelationship among MRF, LBW, and behavioural factors in adolescents. Methods: The sample of the present cross-sectional study comprised 491 youth (229 males, 262 females) aged 14–17 years. Height, weight, and BMI were assessed. Cardiorespiratory fitness (CRF) was measured using the PACER test. Physical activity (PA) was evaluated using a 3-day diary. A MRF risk score was calculated using the Z-scores of the five MRF criteria (HDL-C, triglycerides, BP, insulin, and blood glucose). Results: The average values for height, weight, and systolic and diastolic BP were significantly higher in males (p < 0.01); in contrast, females exhibited higher HDL cholesterol and insulin levels (p < 0.01). Boys revealed higher levels of PA (p < 0.01), and they achieved better CRF scores than girls (p < 0.01). BMI emerged as a significant predictor of clustered metabolic risk for both males (β = 0.26; 95% CI, 0.16–0.36) and females (β = 0.02; 95% CI, 0.14–0.30); additionally, the results indicated that more physically active girls had a notably lower metabolic risk (β = −0.01; 95% CI, −0.10–−0.01) than their male peers. Conclusions: LBW was found to be independently correlated with the aggregated MRF (β = −0.01; 95% CI, −0.01–0.00) among boys aged 14–17 years.

Burn Period: A Use-Inspired Metric to Track Wildfire Risk across Arizona and New Mexico in the Southwest United States

Abstract Numerous tools and indices exist for wildland fire managers to anticipate and track changes in wildfire risk driven by variability in weather and climate conditions at hourly to seasonal scales. However, in working closely with Southwest U.S. managers, we learned of a simple meteorological metric being informally used, but not widely accessible in existing tools or information products, to gauge short-term changes in wildfire risk. This metric, termed “Burn Period” (BP), is the local count of hours per day with relative humidity values equal to or less than 20%. Our collaboration led to the development of an experimental tool called the “Burn Period Tracker” to ease access and promote the use of BP values for planning and response. This study is a climatological analysis of BP values at 124 fire weather stations across Arizona and New Mexico for the period 2000–22 to aid in interpretation and understanding of this use-inspired metric. BP values reflect the strong seasonality in temperature and moisture deficit–driven wildfire risk across the Southwest United States, with risk climbing through the arid spring season, peaking in June, and then falling rapidly with the onset of the summer monsoon in July. Regression analyses show that short-term variability in BP values is driven by variability in low-level atmospheric moisture in all months with strongest relationships during the summer after the onset of the monsoon. This study highlights the utility of BP as a short-term wildfire planning tool as well as an example of collaborative weather and climate services development.

ГЕМОДИНАМИЧЕСКИЕ ПОКАЗАТЕЛИ У ЖЕНЩИН С ГИПЕРТЕНЗИВНЫМИ РАССТРОЙСТВАМИ ВО ВРЕМЯ БЕРЕМЕННОСТИ

Аn analysis of blood pressure (hereinafter referred to as BP) and derived hemodynamic parameters was performed in women with hypertension that existed previously (n=40) or was caused by pregnancy (n=40) and 30 women without hypertensive disorders during pregnancy. It was established that at the stage of pre-pregnancy preparation and during pregnancy, the recommended values of office and home BP should be in the range of optimal BP values according to the modern classification of BP threshold values for optimal, elevated pressure and hypertension (ESH, 2024). Blood pressure corresponding to elevated pressure (120/70 mm Hg and higher) should be considered as a risk factor for the development of hypertensive disorders during pregnancy.

The relationship between lung MIBG uptake and clinical response to renal denervation

Abstract Background Renal denervation (RDN) reduces the sympathetic overdrive and can optimize blood pressure control in patients with difficult-to-treat hypertension (DTH). However, a substantial proportion of patients undergoing RDN do not show a clinical response to the procedure, making it critical to identify novel and more accurate predictors. The metaiodobenzylguanidine (MIBG) scintigraphy allows non-invasive assessment of sympathetic nerve activity. Yet, studies evaluating the heart and kidney MIBG uptake as predictors of clinical response to RDN provided conflicting results, and a comprehensive evaluation of the MIBG uptake in different organs of DTH patients undergoing RDN is lacking. Purpose To explore if a more comprehensive evaluation of MBG uptake in the kidneys, heart and lungs can predict the clinical response to RDN. Methods Eighteen patients with DTH underwent evaluation of their clinical and pharmacological history, office and ambulatory BP values and levels of cardiovascular risk factors. A rest echocardiography, carotid vascular ultrasound and MIBG scintigraphy were also performed before RDN. The patient’s pharmacological history and office and ambulatory BP values were re-evaluated after 3 months from RDN. We considered responders (R) those subjects with a significant reduction of the office BP values on stable BP-lowering treatment or a reduced burden of BP-lowering medications while maintaining optimal control of the office BP. Results Ten patients could be classified as R (1 woman, mean age 49±10 years), while 7 were non-responders (NR, 2 women, mean age 53±8 years). The reduction in office systolic and diastolic BP (baseline vs 3 months) was significantly larger in R vs NR (p=0.01 for both). The burden of BP-lowering medications after the procedure was reduced by 39% in R, compared to 2% in NR (p<0.01). Responders had a higher baseline HR and prevalence of carotid atherosclerosis than NR (p<0.05 for both). In early MIBG acquisitions, the lung/mediastinum ratio on both sides showed higher MIBG uptake in R vs NR (p<0.05). There was a higher MIBG uptake in the right vs. left lung in the whole population and in R vs NR. In late acquisitions, only the left side showed a significant difference between R and NR (p<0.05). The associations between the lung/mediastinum ratio MIBG uptake and response to RDN remained significant after adjusting for the baseline clinical predictors of the RDN response. All other MIBG scintigraphy parameters were similar between groups. Conclusions Our results suggest that RDN might be less effective in patients with an advanced burden of hypertension-mediated target organ damage and confirm a higher HR as a reliable predictor of the clinical response to the procedure. We also document a novel association between the lung/mediastinum ratio MIBG uptake and response to RDN that, if confirmed in future studies, might provide a novel marker to improve the selection of patients undergoing RDN.

Unleashing the potential: early evaluation of blood pressure control with novel measurements in patients with hypertension

Abstract Objective To assess the prognostic value of two novel blood pressure measurements——short-term cumulative systolic blood pressure (SBP) load and Time in Target Rang (TTR) in major adverse cardiovascular outcomes and all-cause mortality. Method This is a post-hoc analysis of the SPIRNT (Systolic Blood Pressure Intervention Trial). Participants with complete record of BP values and no adverse events occurred in the initial 90-days follow-up were enrolled. Short-term cumulative SBP load and TTR were calculated by the 3-month SBP values in the follow-up period (Fig 1). The primary outcome was major adverse cardiovascular events (MACEs), defined as the composite of myocardial infarction, stroke, heart failure and cardiovascular death. Secondary outcomes were the components of the primary outcomes and all-cause mortality. Results The study population included 8639 adults (median [IQR]or mean (%) baseline age, 67 [61,76] years; 2940 women (35.1%); Median follow-up time 3.8[3.3-4.4] years). 559 MACEs were occurred. Participants categorized by tertiles of cumulative SBP Load (T1: [0,0.1572]; T2: (0.1572 ,3.5946]; T3: (3.5946 ,30.2949]) showed a significant increase hierarchical trend (P for trend <0.05) in the incidence of MACEs and stroke. For Participants grouped by SBP TTR (T1: [0,21.2657]; T2: (21.2657 ,71.1462]; T3: (71.1462 ,100]), it indicated a decrease hierarchical trend (P for trend <0.05) in the incidence of MACEs and MI (Fig2 and Fig3). Both short-term cumulative SBP Load (HR: 1.117(1.033-1.208)) and TTR (HR: 0.861(0.785-0.945)) were correlated with MACEs independently(tabal1). According to C-statistics and Net Reclassification Indexes (NRI), short-term cumulative SBP Load and TTR both outperformed mean SBP and SBP standard derivation (SD) on the prognosis value of MACEs. Moreover, our results showed that the coefficient of cumulative SBP Load under penalty decreased to 0 with the largest log(lambda),which indicted a major role across 4 different measures in models. (Fig 4). Conclusions Both short-term cumulative SBP load and TTR had an independent prognosis value for MACEs superior to mean SBP and SBP SD in hypertension patients without diabetes. This study provided the evidence of novel BP measurements for early assessment of BP levels after antihypertensive treatment.

Association of different timepoint and threshold of time-in-target-range and MACEs: insight from the SPRINT study

Abstract Objective To evaluate the prognostic value of different timepoint and threshold of systolic blood pressure (SBP) Time in Target Rang (TTR) in Major Adverse Cardiovascular Events (MACEs). Method This is a post-hoc analysis of the SPIRNT (Systolic Blood Pressure Intervention Trial). Participants with complete record of BP values and no adverse events occurred in the initial 2-years follow-up were enrolled. Different SBP TTR indexes was calculated by different timepoint (3 month,12 month,24 month) and threshold (110-130mmHg;110-140mmHg;110-130mmHg for intensive treatment group and 120-140mmHg for standard treatment group) (Fig 1). The primary outcome was major adverse cardiovascular events (MACEs) occurred 2 years later, defined as the composite of myocardial infarction, stroke, heart failure and cardiovascular death. Results A total of 7134 participants in SPIRNT were enrolled in this study. Those SBP TTR indicators with independent predictive value of MACEs were selected by a multivariable COX model adjusted for traditional cardiovascular risk factors (Fig 2). SBP TTR calculated with 110-140mmHg window in 3 months (3month SBP TTR110-140) was considered to be the best predictor of MACEs occurred 2 years later among selected SBP TTR indexes according to c statistics and relative informativeness (Table1). The restricted cubic spline plot was used to evaluate the nonlinear trend of the TTR indicator. In addition, we obtain the cut-off value by looking for the point in the RCS curve with the largest slope change. 0.65 was considered to be the best truncation for 3month SBP TTR110-140(Fig 3). Patients with 3month TTR110-140 greater than 0.65 had 23.9% lower incidence of MACEs than patients with TTR less than or equal to 0.65 (HR 0.761[0.592-0978], P=0.033).(Table 2) In addition, for patients with early SBP control (3month SBP TTR110-140 >0.65), there was no significant difference in mean SBP between 110-130 mmHg and 130-140 mmHg (Fig4 Group1 Vs Group2). Lasso regression also suggests that TTR110-140 has more informatics advantages than TTR110-130 in cox model at different timepoints (Fig5). Conclusions 3month SBP TTR110-140 was considered to be the best predictor of MACEs occurred 2 years later in different SBP TTR indexes, which indicated the importance of early SBP control. This study also proposed 0.65 as the critical value of 3-month SBP TTR110-140 for prevention of the incident of MACEs. In the future, more cohort studies are needed to expend these findings.

Masked hypertension is highly prevalent among patients with high-normal office blood pressure - based on the results of the Hungarian ABPM Registry

Abstract Background Current European guidelines recommend initiating antihypertensive treatment for patients with high-normal office blood pressure (HNOBP) if their cardiovascular (CV) risk is very high.1 Ambulatory blood pressure monitoring (ABPM) is a recommended tool to identify whitecoat- (WCH) and masked hypertension (MH), and both conditions can be present in patients with HNOBP. Purpose The purpose of our study was to assess the prevalence of white-coat and masked hypertension in patients with HNOBP, the proportion of very high CV risk, and to identify the predictors of WCH and MH. Methods We collected data from the Hungarian ABPM Registry, which is an ongoing, multicenter, open-label, observational study including 38720 adult patients. ABPMs were performed with validated Meditech ABPM-06 monitors. We analyzed the ABPM curves of 4389 HNOBP patients. In the diagnosis of hypertension, 24 hour-, daytime- and nighttime mean BP values were each considered separately. OBP measurements and ABPMs were performed by GPs, internists and cardiologists. 89 patients were excluded due to missing data. Results ABPM recordings confirmed MH in 67.4%(n=2899) of the cases, while WCH in 15.3%(n=659). In 17.3%(n=742) BP was in HN category both in the office and with ABPM (apparent high-normal blood pressure /appHNBP/). WCH patients (57.11±17.47) were older, than appHNBP (54.54±16.9), and MH patients (53.38±16.70)(p<0.001). WCH (19.4%, n=489) and appHNBP (19.4%, n=488) were more frequent among females, than in males (14.3%, n=254; 9.6%, n=170, respectively, p<0.001). However, MH was more prevalent in males compared to females (76.2%(n=1355) vs 61.2%(n=1544), respectively, p<0.001). Snoring, obesity and diabetes mellitus were more frequent in MH than in appHNBP and WHC patients (Snoring: 30.6%(n=887) vs. 25.7%(n=191) vs. 20.8%(n=137), p<0.001; Obesity: 22.9%(n=663) vs. 16.0%(n=119) vs. 13.4%(n=88), p<0.001;Diabetes mellitus: 12.1%(n=350) vs. 8.9%(n=66) vs. 9.9%(n=65), respectively, p=0.025). Independent predictors of WCH were age (OR=1.01[1.003;1.02]), female sex (OR=1.50[1.19;1.89]) and snoring (OR=0.76[0.59;0.97]). Independent predictors of MH were male sex (OR=1.69[1.43;2.00]), snoring (OR=1.27[1.06;1.53]) and obesity (OR=1.55[1.25;1.92]). 76% of all patients received antihypertensive treatment irrespective of the BP groups (WCH: 76.2%(n=502), appHNBP: 76.3%(n=566), MH: 76.5%(n=2217), p=NS). 11.7%(n=502) of all patients had very high CV risk and only 2.5%(n=25) did not receive antihypertensive treatment. Similar results were found among WCH, appHNBP and MH patients (very high CV risk: 13.8%(n=91) vs. 11.2%(n=83) vs.11.7%(n=328), p=NS; no treatment: 1.9%(n=3) vs. 1.7%(n=3) vs. 2.8%(n=19), p=NS). Conclusions In patients with HNOBP, MH is highly prevalent. MH might be suspected in young, obese, male patients with diabetes mellitus and snoring. WCH was more frequent in older females. Based on our data, the majority of patients with HNOBP and very high CV risk are treated.

De-novo transcriptome of anterior epimorphic regeneration in Perionyx excavatus

Perionyx excavatus, an indigenous earthworm possesses exceptional regeneration capacity. Their anterior regeneration features wound closure, regeneration induction and morphogenesis of damaged organs. This study involved a complete analysis of their transcriptomic dataset, with an emphasis on identifying the genes expressed during regeneration and predicting their implications in the process of regeneration and morphogenesis. Control (first ten segments) and test (5th day blastema) RNA samples of biological replicates were isolated and sequenced on NovaSeq. 6000 using PE150 read length. An average of 98.64% of high-quality data was retained with assembly showing better continuity with the average transcript length with 823 bp and N50 value of 1,858 bp. This is the first report on the comparative transcriptome of P. excavatus during anterior regeneration and this study will shed light on the complexity of annelid regeneration.

Real-world analysis of two ischaemic stroke and TIA systolic blood pressure goals on 12-month mortality and recurrent vascular events

IntroductionWhether obtaining the more intensive goal systolic blood pressure (SBP) of <130 mm Hg, rather than a less intensive SBP goal of <140 mm Hg poststroke/transient ischaemic attack (TIA) is...

Orthostatic blood pressure phenotypes prevalence in type 2 diabetes mellitus

Background and aims Orthostatic hypotension (Ohypo) and hypertension (Ohyper) have emerged early markers for high risk of cardiovascular events. Data on the prevalence and risk factors of Ohypo and Ohyper in patients with type 2 diabetes (T2D) are scarce. Methods Within the framework of the Brazilian Diabetes Study, this is an observational, cross-sectional study. The diagnosis of Ohypo was based on drops in systolic blood pressure (SBP) ≥20mmHg or diastolic blood pressure (DBP) ≥10mmHg when transitioning from sitting to standing. Ohyper was defined by either a SBP increase ≥20mmHg during this transition or a sustained elevation to 140 mmHg in otherwise normotensive individuals. Results The study population (n = 900) had a mean age of 57 ± 8 years, 57% male and the median T2D duration was 8 years. Sitting SBP and DBP were 140 ± 20 mmHg and 82 ± 11 mmHg, respectively. Of the total sample, 108 (12%) had Ohypo and 83 (9%) had Ohyper. Each 1-year increase in age was associated with 3.7% higher odds of orthostatic hypotension (OHypo). Additionally, each 1 mmHg increase in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) corresponded to a 3.0, 5.5, and 5.4% increase in the odds of OHypo, respectively. Ohyper risk did not associate with age but showed an inverse relationship with sitting BP values. Conclusions Ohypo and Ohyper are common occurrences in patients with T2D. Advanced age significantly elevates the risk of developing Ohypo, whereas sitting BP emerges as an independent risk factor for both Ohypo and Ohyper.

To Investigate the Prevalence of White Coat Hypertension in Community Dwelling Older Adults Referred for a Falls Assessment

Abstract Background Falls and frailty are the main focus in our integrated care programme for older persons (ICPOP). Office blood pressure (OBP) measurements are commonly used in practice although out of office recordings are proven to be a better predictor of cardiovascular risk (Myers et al, 2018). The European Society of Cardiology guidelines (ESC, 2018) have proposed BP values for the classification of hypertension (HTN). Methods We retrospectively completed a chart review on older adults’ who attended ICPOP with a referral for a falls assessment from November 2021 to April 2024. OBP were obtained after the patient was in the hub for approximately one hour following their comprehensive geriatric assessment (CGA). The OBP was documented following a supine period of 5 minutes. We compared the OBP and ambulatory blood pressure monitor (ABPm) average readings to assess the prevalence of HTN based on the ESC guidelines. Results 75 charts were reviewed. 3 ABPm recordings were unsuccessful due to cognitive impairment or not tolerating the ABPm. These were excluded from the audit. No patient had hypotension on either their OBP or ABPm recordings. On their OBP recordings, 29/72 (40%) had a normal reading while 43/72 (60%) had HTN. On their ABPm 54/72 (75%) had a normal reading while 18/72 (25%) had HTN. When we looked at antihypertensive medication use in those who had a normal reading on their ABPm, 47/54 (87%) were on antihypertensive treatment. All patients with HTN on their ABPM were on antihypertensive treatment. Conclusion Our findings suggest that OBP readings greatly increase the numbers of patients diagnosed with HTN compared to ABPm (60% versus 25%). Therefore, we suggest that all patients should have an ABPm as a gold standard to falls assessment to avoid over-treating white coat HTN.

Design, Formulation, and Optimization of Nicardipine-Loaded Gastroretentive Floating Microspheres: In-vitro, Ex-vivo and In-vivo Characterization.

Nicardipine hydrochloride is highly soluble at low pH values. The objective of this investigation was to design, manufacture, and refine the drug’s floating microspheres to increase its bioavailability and prolong its period of residence in the gastrointestinal tract. To optimize the Box-Behken and prepare the floating microspheres, solvent evaporation was employed. The formulation F5 was discovered to be the best as anticipated by the design expert software’s point prediction. Evaluations of pre- and postcompressional parameters were conducted. Utilizing several kinetic models, the drug release pathways were examined. The drugs and excipients did not interact, according to the FTIR/DSC investigations. According to the radiological approach, F5 showed good in-vitro buoyancy. The gastroretentive property of microspheres is revealed by X-ray pictures obtained at 2, 8, and 12 hours for the buoyancy investigation. F5 (235.04%) demonstrated a high relative bioavailability over oral tablets, according to the in-vivo pharmacokinetic investigation. In comparison to the marketed formulation group, the F5-treated group experienced a considerably larger percent decline in BP values (20.00 ± 6.00 and 13.00 ± 4.00%, respectively) at 36 and 48 hours of the in-vivo pharmacodynamic testing. For 90 days, the F5 formulation was maintained at 5 ± 2 and 25 ± 2°C, indicating the stability of nicardipine microspheres.

Geochemical Indicators on the Central Tibetan Plateau Lake Sediments: Historical Climate Change and Regional Sustainability

This study investigates geochemical indicators (TOC, TN, C/N, δ13Corg, δ15N, and pollen indicators) from sediment samples of Zigetang Co Lake on the Tibetan Plateau (TP) to explore past climate changes in the lake basin. The findings aim to provide essential data for developing sustainable strategies for the TP region. From 14.0 to 10.8 cal. ka BP, the δ15N, TOC, TN, and δ13Corg value of the lake sediments was relatively low; this indicated a low organic matter input into the lake, reflecting a probably cold and arid environment. In addition, the pollen was primarily composed of Artemisia and Gramineae, which are adapted to cold environments, further confirming that the climate during this period was likely cold and dry. From 10.8 to 8.2 cal. ka BP, the changes in the main plant composition were likely due to increased solar radiation, the onset of the monsoon, and higher temperatures and precipitation, which created more favorable conditions for the growth of Cyperaceae. From 8.2 to 4.2 cal. ka BP, when the solar radiation weakened and the monsoon diminished, the basin maintained relatively high water levels, with regional precipitation being likely influenced by westerly winds. From 4.2 to 0.01 cal. ka BP, δ13Corg and δ15N initially decreased and then increased, which was likely a transition from a cold–wet climate to warm–dry conditions during the late Holocene, and the Pollen sum also showed significant changes. Understanding climate evolution and vegetation changes is crucial for formulating timely policies to ensure regional sustainable development.

The Effectiveness of Exercise in Reducing Cardiovascular Risk Factors Among Adults: A Systematic Review and Meta-Analysis.

Cardiovascular disease (CVD) remains one of the major causes of sickness and death in the world. However, lifestyle modifications, such as exercise, can significantly reduce the risk of this disease. This study aimed to assess the effectiveness of various forms of physical activity in reducing CVD risk factors among adults. A comprehensive search of the databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and Excerpta Medica Database (EMBASE) databases was conducted between January 1, 2014, and May 31, 2024, as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs), cohort studies, and observational studies on the impact of aerobic, resistance, or combined training on cardiovascular risk factors in adults (≥18 years) were considered for inclusion. Data relating to primary outcomes, including stroke and myocardial infarction rates, BP, cholesterol levels, and BMIwere collected. The Cochrane risk-of-bias tool and the Methodological Index for Non-Randomized Studies (MINORS) checklist were used for quality and bias assessment. Meta-analyses were performed using the RevMan software, with heterogeneity evaluated by I² statistics; 17 studies, including 11 RCTs and six cohort studies, met the inclusion criteria. There was a significant reduction in the mean systolic BP (SBP) by 3.32 mmHg [95% confidence interval (CI): 0.85-5.78 mmHg; p<0.0001] and mean diastolic BP (DBP) by 2.99 mmHg (95% CI: 2.34-3.64 mmHg; p < 0.00001) after exercise interventions. Moreover, cholesterol levels and BMI values improved with exercise. Those who exercised had a lower risk of stroke or heart attack compared with the controls [odds ratio (OR): 0.57; 95% CI: 0.28-1.14; p >0.0001], although there was substantial heterogeneity in effect size across the studies (I² = 98%). Different types of physical activity (i.e., aerobic, resistance, or combined exercise) can effectively reduce key cardiovascular risk factors, including BP, cholesterol levels, and BMI values. Regular physical activity is still regarded as the most effective preventive measure against CVD, despite inconsistencies in research findings. Future studies should aim to identify optimal exercise programs and their long-term effects on diverse populations.

P168 CHARACTERIZATION OF THE HEMODYNAMIC PATTERN OF CONTROLLED HYPERTENSIVE PATIENTS

Background: Hemodynamic alterations have been described in hypertensive disease. However, we still do not know if the identification of an altered hemodynamic pattern in patients with controlled hypertension could predict cardiovascular risk or evolution of hypertension. Objective: to identify the hemodynamic pattern of hypertensive patients with BP values in goals. Methods: Controlled hypertensive subjects were recruited (n = 107) and included a control group of normotensive subjects (n: 35.9). A non-invasive hemodynamic study (Z Logic, lying down / standing) was performed, and the cardiac index (CI) and vascular resistance index (VRI) data were recorded for the determination of the hemodynamic pattern. Hypodynamic pattern was considered: CI &lt;2.5 L / min / m2 and VRI&gt; 2500 dynas.seg.cm-5.m2; Hyperdynamic pattern IC&gt; 4,4 L / min / m2 and VRI &lt;2500 dynas.seg.cm-5.m2 Results: The SBP / DBP of the HTA group was 133.09 +/- 6.01 / 82.4 +/-7.2 mm Hg; and of the NT group was SBP/ DBP 123.6 +/- 9.7 / 75.5 +/- 8.9. The CI and VRI of the HTA group obtained was 2.81 l / m2 / min and 2842.31 dynas that, without corresponding to a hypodynamic pattern, showed a predominance of the VRI increase. In the control group of NT subjects, the values were 3.23 and 2289.23, respectively, corresponding to a normal pattern. The values obtained were different between both groups (p &lt;.05). Conclusions: Controlled hypertensive patients with hypertension goals have a hemodynamics pattern with an increase in the VRI different from that of normotensive subjects. These results coincide with those reported by Ferrario and col. The relevance of the imbalance found could only be analyzed in the context of long-term follow-up to identify whether it is a predictor of CV events and / or complications.

P154 GETTING OPTIMAL AND TARGET BLOOD PRESSURE IS MORE CHALLENGING FOR HYPERTENSIVE PATIENTS WITH ANOTHER CARDIOVASCULAR DISEASE

Home blood pressure monitoring (HBPM) compared with office-based monitoring could be better at predicting cardiovascular morbidity and mortality. Patients and Methods: This project aimed to evaluate HBPM in adult pts with AH. It was conducted from April to June 2022 at 178 general physicians practices in Slovakia. Results: 4375 pts with AH were enrolled (2089 women, 51,8%), mean age 61,1 ± 19,1 years. BP values at HBPM decreased over the period of seven days by -2.2/-1.4 mm Hg (p &lt; 0.01). The first treatment goal, office BP ≤ 140/90 mm Hg, was achieved by 67% of patients. The second treatment goal, based on patients’ age was achieved by 35% of patients. The number of patients with CV comorbidities surpassed 48.8%. They were significantly older 67,3± 15,2 years vs 57,1 ± 12,6 years (p&lt;0,01), with a higher BMI of 30,1± 5,2 kg/m2vs 28,7 ± 3,8 kg/m2 (p&lt;0,01) in comparison with patients without CV comorbidities. In HBPM patients with CV comorbidities have higher both systolic BP (SBP) and diastolic BP (DBP) 134,8 ± 11,2/80,3± 7,6 mmHg vs 131,9±8,2/80,4 ±6,4 mmHg (p&lt;0,01). To compare with office blood pressure measurements: higher SBP was in patients with CV comorbidities 137,1 ±18,1 mmHg vs 135,2 ±16,3 mmHg (p 0,516), higher DBP was in patients without CV comorbidities 81,5 ±6,4 mmHg vs 80,3 ± 5,1 mmHg (p&lt;0,01). Dyslipidemia was present in 67% of patients. Women were more likely to have dyslipidemia and hypertension 68,8% vs 65,5% (p=0.03) in men. Conclusions: The results of office and home BPM 2022 demonstrated active involvement of patients in the management of AH can have a significant impact. We need to be more consistent in treating AH, according to 2023 ESH guidelines, mainly in patients with cardiovascular comorbidities. By achieving a 67% success rate in control of AH patients, The Charter 70/2023 is imminent.

P118 EFFECT OF A FIXED COMBINATION THERAPY WITH PERINDOPRIL/AMLODIPINE AND ROSUVASTATIN TO PATIENTS WITH HIGH AND VERY HIGH RISK HYPERTENSION AND DYSLIPEDEMIA

Purpose: Assess achievement target level blood pressure, LDL cholesterol, non-HDL cholesterol, Triglyceride, patients with high, very high risk AH during 6-month therapy with fixed combination perindopril/amlodipine addition rosuvastatin. Material, methods: Study included 43 patients hypertension I-II degrees (ESC/ESH, 2018), All patients assessed for cardiovascular risk using the SCORE2scale, high risk identified n=34 (80%) patients, very high n=9 (20%) patients. Average age patients 58.23±9.82 years, the average duration hypertension 13.07±8.53 years. SBP 159.46±10.52 mmHg, DBP 91.69±8.60 mmHg. All patients underwent: determination level blood lipids, glucose, ALT, AST, CPK, creatinine, uric acid in the blood and microalbuminuria. All patients with AHT and hypolipidemic purposes prescribed fixed combination drug perindopril/amlodipine and rosuvastatin. Drug dose titrated every 2 weeks until target values of BP and LDL cholesterol (&lt;100-70 mg/dl), non-HDL cholesterol (&lt;100-85 mg/dl), TG (&lt;150 mg/dl) achieved. Average drug doses were perindopril at dose 4 to 8 mg/day, amlodipine dose 5 to 10 mg/day, initial dose orosuvastatin10 mg/day. All types analysis, p values &lt;0.05 were considered statistically significant (Wilcoxontest). Results: In general, 6-month combination therapy with perindopril/amlodipine, rosuvastatin showed high lipotensive effectiveness. There was significant decrease in scores SCORE2scale, LDL cholesterol, non-HDL cholesterol, TG, SBP, DBP, blood pressure. The degree of scores SCORE2scale: initially 20.92±8.05 dynamics 14.92±9.66 points (p&lt;0.001); LDL cholesterol 146.53±35.90,dynamics 114.86±36.43 mg/dl (p&lt;0.003); Non-HDL cholesterol 185.61±35.90 mg/dl, dynamics 143.25±37.01 mg/dl (p&lt;0.079); TG 181.23±108.47 dynamics 143.90±64.47 mg/dl (p&lt;0.006); SBP 159.84±9 mmHg, dynamics 131.65±5.93 mmHg (p&lt;0.000); DBP 91.69±8.60 mmHg, dynamics 82.55±4.17 mmHg(p&lt;0.000); BPmean 115.48±7.22 mmHg, dynamics 99.96±3.75 mmHg. (p&lt;0.000). In addition SBP decreased by -16.86±4.70%, DBP by -8.16±6.99%. The target level LDL cholesterol reached by39% patients, non-HDL cholesterol by 18%, Triglycerides by 55%, the target level SBP reached 88%, DBP 81% patients, SBP and DBP simultaneously 81% patients. Conclusion: Analysis effectiveness of combination therapy with drug perindopril/amlodipine, rosuvastatin showed significant decrease in level of indicators SCORE2 scores, LDL cholesterol, non-HDL cholesterol, TG, SBP, DBP, blood pressure. In patients with high, very high risk hypertension.

Abstract P386: Predictors of Home Blood Pressure Response to Ultrasound Renal Denervation

Background: Out-of-office blood pressure measurements are recommended for hypertension (HTN) management. The RADIANCE clinical trial program showed that ultrasound renal denervation (uRDN) significantly reduces daytime ambulatory systolic blood pressure (SBP) in patients with mild-to-moderate HTN (RADIANCE-HTN SOLO, RADIANCE II) and resistant HTN (RADIANCE-HTN TRIO). Previous analyses have assessed predictors of daytime ambulatory SBP response at 2-months. This analysis assessed predictors of home SBP (HSBP) at 2-months. Method: This analysis included 250 patients who were randomized to and received uRDN and were treated per-protocol. Separate linear regression models were used to assess predictors of the change in HSBP at 2-months. Multivariable regression analysis was conducted including variables with p-value&lt;0.20. Backward selection with a stay criterion of 0.20 was used to select the predictors for the final multivariable analysis. Study was pre-defined as a covariate in the final model. Results: Patients were 69% male and 76% white; average age was 53.9 years and baseline office BP 155.5/101.5 mmHg. The only significant predictor (p&lt; 0.05) resulting from the separate linear regression models adjusting for cohort was baseline HSBP. Other predictors included in the multivariable analyses (p&lt;0.20) were sex, black race, screening medications(Y/N), orthostatic HTN, and right renal artery diameter. In the multivariable analyses, baseline HSBP was the only significant predictor of change in HSBP at 2-months (p=0.009, See Table). Conclusions: In this analysis of response to treatment with uRDN using home BPs, baseline HSBP was the only consistent significant predictor of response. Baseline BP value as a predictor of RDN response is consistent with prior analyses.

In silico analysis of drug-resistant genes of Staphylococcus aureus

Drug-resistant strains of pathogenic bacteria are recently considered a devastating health problem. Staphylococcus aureus is a bacterium that commonly lives on the skin and in the nasal passages of approximately one-third of the population without causing any harm. One of the major concerns with Staphylococcus aureus is its ability to develop antibiotic resistance. Drug-resistant genes play an important role in determining the characteristics of bacteria mechanisms of drug resistance. The identification of promoters in a gene is an important part of the recognition of a gene's complete structure. An in silico study was done to analyze the promoter regions and transcription factors with the aid of the transcription start site, regulatory elements, and motifs of genes. Most of the predicted transcription start sites (75 %) were found above 500 bp value either upstream or downstream from the start codon of the gene being expressed. Motif I was identified as the most common motif for the predicted genes, which serves as binding sites to regulate the expression of the genes. A variety of regulatory elements including enhancers, insulators, transcription factors, and cellular proteins are involved in the regulation of gene expression. In general, in silico analysis of drug-resistant genes of Staphylococcus aureus could provide valuable insights about the transcription factor binding, and gene regulatory elements in the promoter regions that can lead to promising research targets in drug designing and development. Therefore, further studies should be made to study resistance-related proteins, the protein-protein interaction networks, the pathways involved in mechanisms underlying resistance, and facilitating the design of target-specific drugs.