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1. Guía práctica sobre el diagnóstico y tratamiento de la hipertensión arterial en España, 2022. Sociedad Española de Hipertensión - Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA)

Author

Gorostidi, M., Gijón-Conde, T., de la Sierra, A., Rodilla, E., Rubio, E., Vinyoles, E., Oliveras, A., Santamaría, R., Segura, J., Molinero, A., Pérez-Manchón, D., Abad, M., Abellán, J., Armario, P., Banegas, J.R., Camafort, M., Catalina, C., Coca, A., Divisón, J.A., Domenech, M., Martell, N., Martín-Rioboó, E., Morales-Olivas, F., Pallarés, V., Pérez de Isla, L., Prieto, M.A., Redón, J., Ruilope, L.M., and García-Donaire, J.A.

Published
2022
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2. Assessment and Management of Patients with Obesity and Hypertension in European Society of Hypertension Excellence Centres. A survey from the ESH Working Group on Diabetes and Metabolic Risk Factors

Author

Antza, C, Grassi, G, Weber, T, Persu, A, Jordan, J, Nilsson, P, Redon, J, Stabouli, S, Kreutz, R, Kotsis, V, Antza, Christina, Grassi, Guido, Weber, Thomas, Persu, Alexandre, Jordan, Jens, Nilsson, Peter M, Redon, Josep, Stabouli, Stella, Kreutz, Reinhold, Kotsis, Vasilios, Antza, C, Grassi, G, Weber, T, Persu, A, Jordan, J, Nilsson, P, Redon, J, Stabouli, S, Kreutz, R, Kotsis, V, Antza, Christina, Grassi, Guido, Weber, Thomas, Persu, Alexandre, Jordan, Jens, Nilsson, Peter M, Redon, Josep, Stabouli, Stella, Kreutz, Reinhold, and Kotsis, Vasilios

Abstract

Background: Healthcare providers are faced with an increasing number of patients with obesity and arterial hypertension. Preventing obesity-associated hypertension and appropriately managing patients with established disease are both important. Hence, the aim of our study was to evaluate the clinical care of patients with obesity and hypertension among ESH Excellence Centres (ECs). Methods: We conducted a cross-sectional, international 30-item survey through e-mails. Results: In total, 70 representatives of ECs participated (78% men) with 66% of them practicing medicine for more than 30 years and working in well-equipped clinics. Most were internists (41%) and cardiologists (37%) and 73% reported training on the management of obese patients with hypertension. A majority weigh their patients (77%) and evaluate patients for sleep disorders (93%). However, only 47% spend more than 5min to advise for lifestyle modification in general, 59% for weight loss, 56% for salt intake and 64% for exercise. Finally, a minority of participants ask patients if they like their body (6%) or about previous attempts to lose weight (28%), evaluate 24h urinary sodium excretion rate (22%) and provide written (15%) or personalized (10%) dietary advices. If the patient suffers also from type 2 diabetes mellitus, 66% switch treatment to GLP1 receptor agonists and 60% to SGLT2 inhibitors. Conclusion: Most clinicians in ESH ECs are well educated regarding obesity-associated hypertension, and clinics are sufficiently equipped to manage these patients, as well. However, several deficits were reported regarding efforts to address and implement obesity specific aspects and interventions to improve care in patients with obesity and hypertension.

Published
2024

7. Insights From Matched Office and Ambulatory Blood Pressure in Youth: Clinical Relevance

Author

Lurbe, E, Redon, J, Alvarez, J, Grau-Perez, M, Martinez, F, Mancia, G, Lurbe E., Redon J., Alvarez J., Grau-Perez M., Martinez F., Mancia G., Lurbe, E, Redon, J, Alvarez, J, Grau-Perez, M, Martinez, F, Mancia, G, Lurbe E., Redon J., Alvarez J., Grau-Perez M., Martinez F., and Mancia G.

Abstract

Background: Information on the relationship between ambulatory blood pressure (ABP) and concurrently office blood pressure (BP) values in youth still suffers from limitations. We provide information on the differences between office BP and ABP, the factors related, and the clinical implications. Methods: Three thousand six hundred ninety matched measurements of office BP and ABP on the same day, from 2390 children, aged 5 to 15 years, of both sexes were eligible. Office BP was measured using an oscillometric device (Omron 705 IT) and 24-hour ABP using oscillometric SpaceLabs 90207. Average of office, 24-hour, daytime, nighttime, systolic, and diastolic BP and heart rate was calculated. BP categories according to the European guidelines and phenotype of mismatch office BP versus ABP were defined. Results: Both daytime systolic and diastolic BP were higher than office BP with a progressive reduction of the differences from 5 to 15 years. The office minus daytime BP differences were the largest in normotensive subjects, less at high-normal, and reversed in hypertensive ones, independently of age and weight status. White coat and masked hypertension covered no more than 13.6% at all ages. Conclusions: In youth, it is inaccurate to obtain reference values for ABP by extrapolating from office BP values. The differences between office BP and ABP are minimal in children with office BP values in the range of hypertension, reinforcing the recommendation to use ABP measurement at the time to confirm hypertension.

Published
2022

8. Narrative update of clinical trials with antihypertensive drugs in children and adolescents

Author

Redon, J, Seeman, T, Pall, D, Suurorg, L, Kamperis, K, Erdine, S, Wuhl, E, Mancia, G, Redon J., Seeman T., Pall D., Suurorg L., Kamperis K., Erdine S., Wuhl E., Mancia G., Redon, J, Seeman, T, Pall, D, Suurorg, L, Kamperis, K, Erdine, S, Wuhl, E, Mancia, G, Redon J., Seeman T., Pall D., Suurorg L., Kamperis K., Erdine S., Wuhl E., and Mancia G.

Abstract

Introduction: To date, our knowledge on antihypertensive pharmacological treatment in children and adolescents is still limited because there are few randomized clinical trials (CTs), hampering appropriate management. The objective was to perform a narrative review of the most relevant aspects of clinical trials carried out in primary and secondary hypertension. Methods: Studies published in PubMed with the following descriptors: clinical trial, antihypertensive drug, children, adolescents were selected. A previous Cochrane review of 21 randomized CTs pointed out the difficulty that statistical analysis could not assess heterogeneity because there were not enough data. A more recent meta-analysis, that applied more stringent inclusion criteria and selected 13 CTs, also concluded that heterogeneity, small sample size, and short follow-up time, as well as the absence of studies comparing drugs of different classes, limit the utility. Results: In the presented narrative review, including 30 studies, there is a paucity of CTs focusing only on children with primary or secondary, mainly renoparenchymal, hypertension. In trials on angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs) and diuretics, a significant reduction of both SBP and DBP in mixed cohorts of children with primary and secondary hypertension was achieved. However, few studies assessed the effect of antihypertensive drugs on hypertensive organ damage. Conclusions: Given the increasing prevalence and undertreatment of hypertension in this age group, innovative solutions including new design, such as ‘n-of-1', and optimizing the use of digital health technologies could provide more precise and faster information about the efficacy of each antihypertensive drug class and the potential benefits according to patient characteristics.

Published
2022

11. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)

Author

Mancia, G, Kreutz, R, Brunström, M, Burnier, M, Grassi, G, Januszewicz, A, Muiesan, M, Tsioufis, K, Agabiti-Rosei, E, Algharably, E, Azizi, M, Benetos, A, Borghi, C, Hitij, J, Cifkova, R, Coca, A, Cornelissen, V, Cruickshank, J, Cunha, P, Danser, A, Pinho, R, Delles, C, Dominiczak, A, Dorobantu, M, Doumas, M, Fernández-Alfonso, M, Halimi, J, Járai, Z, Jelaković, B, Jordan, J, Kuznetsova, T, Laurent, S, Lovic, D, Lurbe, E, Mahfoud, F, Manolis, A, Miglinas, M, Narkiewicz, K, Niiranen, T, Palatini, P, Parati, G, Pathak, A, Persu, A, Polonia, J, Redon, J, Sarafidis, P, Schmieder, R, Spronck, B, Stabouli, S, Stergiou, G, Taddei, S, Thomopoulos, C, Tomaszewski, M, Van de Borne, P, Wanner, C, Weber, T, Williams, B, Zhang, Z, Kjeldsen, S, Mancia, Giuseppe, Kreutz, Reinhold, Brunström, Mattias, Burnier, Michel, Grassi, Guido, Januszewicz, Andrzej, Muiesan, Maria Lorenza, Tsioufis, Konstantinos, Agabiti-Rosei, Enrico, Algharably, Engi Abd Elhady, Azizi, Michel, Benetos, Athanase, Borghi, Claudio, Hitij, Jana Brguljan, Cifkova, Renata, Coca, Antonio, Cornelissen, Veronique, Cruickshank, J Kennedy, Cunha, Pedro G, Danser, A H Jan, Pinho, Rosa Maria de, Delles, Christian, Dominiczak, Anna F, Dorobantu, Maria, Doumas, Michalis, Fernández-Alfonso, María S, Halimi, Jean-Michel, Járai, Zoltán, Jelaković, Bojan, Jordan, Jens, Kuznetsova, Tatiana, Laurent, Stephane, Lovic, Dragan, Lurbe, Empar, Mahfoud, Felix, Manolis, Athanasios, Miglinas, Marius, Narkiewicz, Krzystof, Niiranen, Teemu, Palatini, Paolo, Parati, Gianfranco, Pathak, Atul, Persu, Alexandre, Polonia, Jorge, Redon, Josep, Sarafidis, Pantelis, Schmieder, Roland, Spronck, Bart, Stabouli, Stella, Stergiou, George, Taddei, Stefano, Thomopoulos, Costas, Tomaszewski, Maciej, Van de Borne, Philippe, Wanner, Christoph, Weber, Thomas, Williams, Bryan, Zhang, Zhen-Yu, Kjeldsen, Sverre E, Mancia, G, Kreutz, R, Brunström, M, Burnier, M, Grassi, G, Januszewicz, A, Muiesan, M, Tsioufis, K, Agabiti-Rosei, E, Algharably, E, Azizi, M, Benetos, A, Borghi, C, Hitij, J, Cifkova, R, Coca, A, Cornelissen, V, Cruickshank, J, Cunha, P, Danser, A, Pinho, R, Delles, C, Dominiczak, A, Dorobantu, M, Doumas, M, Fernández-Alfonso, M, Halimi, J, Járai, Z, Jelaković, B, Jordan, J, Kuznetsova, T, Laurent, S, Lovic, D, Lurbe, E, Mahfoud, F, Manolis, A, Miglinas, M, Narkiewicz, K, Niiranen, T, Palatini, P, Parati, G, Pathak, A, Persu, A, Polonia, J, Redon, J, Sarafidis, P, Schmieder, R, Spronck, B, Stabouli, S, Stergiou, G, Taddei, S, Thomopoulos, C, Tomaszewski, M, Van de Borne, P, Wanner, C, Weber, T, Williams, B, Zhang, Z, Kjeldsen, S, Mancia, Giuseppe, Kreutz, Reinhold, Brunström, Mattias, Burnier, Michel, Grassi, Guido, Januszewicz, Andrzej, Muiesan, Maria Lorenza, Tsioufis, Konstantinos, Agabiti-Rosei, Enrico, Algharably, Engi Abd Elhady, Azizi, Michel, Benetos, Athanase, Borghi, Claudio, Hitij, Jana Brguljan, Cifkova, Renata, Coca, Antonio, Cornelissen, Veronique, Cruickshank, J Kennedy, Cunha, Pedro G, Danser, A H Jan, Pinho, Rosa Maria de, Delles, Christian, Dominiczak, Anna F, Dorobantu, Maria, Doumas, Michalis, Fernández-Alfonso, María S, Halimi, Jean-Michel, Járai, Zoltán, Jelaković, Bojan, Jordan, Jens, Kuznetsova, Tatiana, Laurent, Stephane, Lovic, Dragan, Lurbe, Empar, Mahfoud, Felix, Manolis, Athanasios, Miglinas, Marius, Narkiewicz, Krzystof, Niiranen, Teemu, Palatini, Paolo, Parati, Gianfranco, Pathak, Atul, Persu, Alexandre, Polonia, Jorge, Redon, Josep, Sarafidis, Pantelis, Schmieder, Roland, Spronck, Bart, Stabouli, Stella, Stergiou, George, Taddei, Stefano, Thomopoulos, Costas, Tomaszewski, Maciej, Van de Borne, Philippe, Wanner, Christoph, Weber, Thomas, Williams, Bryan, Zhang, Zhen-Yu, and Kjeldsen, Sverre E

Abstract

Luis Alcocer (Mexico), Christina Antza (Greece), Mustafa Arici (Turkey), Eduardo Barbosa (Brazil), Adel Berbari (Lebanon), Luís Bronze (Portugal), John Chalmers (Australia), Tine De Backer (Belgium), Alejandro de la Sierra (Spain), Kyriakos Dimitriadis (Greece), Dorota Drozdz (Poland), Béatrice Duly-Bouhanick (France), Brent M. Egan (USA), Serap Erdine (Turkey), Claudio Ferri (Italy), Slavomira Filipova (Slovak Republic), Anthony Heagerty (UK), Michael Hecht Olsen (Denmark), Dagmara Hering (Poland), Sang Hyun Ihm (South Korea), Uday Jadhav (India), Manolis Kallistratos (Greece), Kazuomi Kario (Japan), Vasilios Kotsis (Greece), Adi Leiba (Israel), Patricio López-Jaramillo (Colombia), Hans-Peter Marti (Norway), Terry McCormack (UK), Paolo Mulatero (Italy), Dike B. Ojji (Nigeria), Sungha Park (South Korea), Priit Pauklin (Estonia), Sabine Perl (Austria), Arman Postadzhian (Bulgaria), Aleksander Prejbisz (Poland), Venkata Ram (India), Ramiro Sanchez (Argentina), Markus Schlaich (Australia), Alta Schutte (Australia), Cristina Sierra (Spain), Sekib Sokolovic (Bosnia and Herzegovina), Jonas Spaak (Sweden), Dimitrios Terentes-Printzios (Greece), Bruno Trimarco (Italy), Thomas Unger (The Netherlands), Bert-Jan van den Born (The Netherlands), Anna Vachulova (Slovak Republic), Agostino Virdis (Italy), Jiguang Wang (China), Ulrich Wenzel (Germany), Paul Whelton (USA), Jiri Widimsky (Czech Republic), Jacek Wolf (Poland), Grégoire Wuerzner (Switzerland), Eugene Yang (USA), Yuqing Zhang (China).

Published
2023

12. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants

Author

Zhou, B, Lu, Y, Hajifathalian, K, Bentham, J, Di Cesare, M, Danaei, G, Bixby, H, Cowan, MJ, Ali, MK, Taddei, C, Lo, WC, Reis-Santos, B, Stevens, GA, Riley, LM, Miranda, JJ, Bjerregaard, P, Rivera, JA, Fouad, HM, Ma, G, Mbanya, JC, McGarvey, ST, Mohan, V, Onat, A, Pilav, A, Ramachandran, A, Romdhane, HB, Paciorek, CJ, Bennett, JE, Ezzati, M, Abdeen, ZA, Abdul Kadir, K, Abu-Rmeileh, NM, Acosta-Cazares, B, Adams, R, Aekplakorn, W, Aguilar-Salinas, CA, Agyemang, C, Ahmadvand, A, Al-Othman, AR, Alkerwi, A, Amouyel, P, Amuzu, A, Andersen, LB, Anderssen, SA, Anjana, RM, Aounallah-Skhiri, H, Aris, T, Arlappa, N, Arveiler, D, Assah, FK, Avdicová, M, Azizi, F, Balakrishna, N, Bandosz, P, Barbagallo, CM, Barceló, A, Batieha, AM, Baur, LA, Benet, M, Bernabe-Ortiz, A, Bharadwaj, S, Bhargava, SK, Bi, Y, Bjertness, E, Bjertness, MB, Björkelund, C, Blokstra, A, Bo, S, Boehm, BO, Boissonnet, CP, Bovet, P, Brajkovich, I, Breckenkamp, J, Brenner, H, Brewster, LM, Brian, GR, Bruno, G, Bugge, A, Cabrera de León, A, Can, G, Cândido, AP, Capuano, V, Carlsson, AC, Carvalho, MJ, Casanueva, FF, Casas, JP, Caserta, CA, Castetbon, K, Chamukuttan, S, Chaturvedi, N, Chen, CJ, Chen, F, Chen, S, Cheng, CY, Chetrit, A, Chiou, ST, Cho, Y, Chudek, J, Cifkova, R, Claessens, F, Concin, H, Cooper, C, Cooper, R, Costanzo, S, Cottel, D, Cowell, C, Crujeiras, AB, D'Arrigo, G, Dallongeville, J, Dankner, R, Dauchet, L, de Gaetano, G, De Henauw, S, Deepa, M, Dehghan, A, Deschamps, V, Dhana, K, Di Castelnuovo, AF, Djalalinia, S, Doua, K, Drygas, W, Du, Y, Dzerve, V, Egbagbe, EE, Eggertsen, R, El Ati, J, Elosua, R, Erasmus, RT, Erem, C, Ergor, G, Eriksen, L, Escobedo-de la Peña, J, Fall, CH, Farzadfar, F, Felix-Redondo, FJ, Ferguson, TS, Fernández-Bergés, D, Ferrari, M, Ferreccio, C, Feskens, EJ, Finn, JD, Föger, B, Foo, LH, Forslund, AS, Francis, DK, Franco Mdo, C, Franco, OH, Frontera, G, Furusawa, T, Gaciong, Z, Garnett, SP, Gaspoz, JM, Gasull, M, Gates, L, Geleijnse, JM, Ghasemian, A, Ghimire, A, Giampaoli, S, Gianfagna, F, Giovannelli, J, Giwercman, A, Gross, MG, González Rivas, JP, Gorbea, MB, Gottrand, F, Grafnetter, D, Grodzicki, T, Grøntved, A, Gruden, G, Gu, D, Guan, OP, Guerrero, R, Guessous, I, Guimaraes, AL, Gutierrez, L, Hambleton, IR, Hardy, R, Hari Kumar, R, Hata, J, He, J, Heidemann, C, Herrala, S, Hihtaniemi, IT, Ho, SY, Ho, SC, Hofman, A, Hormiga, CM, Horta, BL, Houti, L, Howitt, C, Htay, TT, Htet, AS, Htike, MM, Hu, Y, Hussieni, AS, Huybrechts, I, Hwalla, N, Iacoviello, L, Iannone, AG, Ibrahim, MM, Ikeda, N, Ikram, MA, Irazola, VE, Islam, M, Iwasaki, M, Jacobs, JM, Jafar, T, Jamil, KM, Jasienska, G, Jiang, CQ, Jonas, JB, Joshi, P, Kafatos, A, Kalter-Leibovici, O, Kasaeian, A, Katz, J, Kaur, P, Kavousi, M, Keinänen-Kiukaanniemi, S, Kelishadi, R, Kengne, AP, Kersting, M, Khader, YS, Khalili, D, Khang, YH, Kiechl, S, Kim, J, Kolsteren, P, Korrovits, P, Kratzer, W, Kromhout, D, Kujala, UM, Kula, K, Kyobutungi, C, Laatikainen, T, Lachat, C, Laid, Y, Lam, TH, Landrove, O, Lanska, V, Lappas, G, Laxmaiah, A, Leclercq, C, Lee, J, Lehtimäki, T, Lekhraj, R, León-Muñoz, LM, Li, Y, Lim, WY, Lima-Costa, MF, Lin, HH, Lin, X, Lissner, L, Lorbeer, R, Lozano, JE, Luksiene, D, Lundqvist, A, Lytsy, P, Machado-Coelho, GL, Machi, S, Maggi, S, Magliano, DJ, Makdisse, M, Mallikharjuna Rao, K, Manios, Y, Manzato, E, Margozzini, P, Marques-Vidal, P, Martorell, R, Masoodi, SR, Mathiesen, EB, Matsha, TE, McFarlane, SR, McLachlan, S, McNulty, BA, Mediene-Benchekor, S, Meirhaeghe, A, Menezes, AM, Merat, S, Meshram, II, Mi, J, Miquel, JF, Mohamed, MK, Mohammad, K, Mohammadifard, N, Mohd Yusoff, MF, Møller, NC, Molnár, D, Mondo, CK, Morejon, A, Moreno, LA, Morgan, K, Moschonis, G, Mossakowska, M, Mostafa, A, Mota, J, Motta, J, Mu, TT, Muiesan, ML, Müller-Nurasyid, M, Mursu, J, Nagel, G, Námešná, J, Nang, EE, NangThetia, VB, Navarrete-Muñoz, EM, Ndiaye, NC, Nenko, I, Nervi, F, Nguyen, ND, Nguyen, QN, Nieto-Martínez, RE, Ning, G, Ninomiya, T, Noale, M, Noto, D, Nsour, MA, Ochoa-Avilés, AM, Oh, K, Ordunez, P, Osmond, C, Otero, JA, Owusu-Dabo, E, Pahomova, E, Palmieri, L, Panda-Jonas, S, Panza, F, Parsaeian, M, Peixoto, SV, Pelletier, C, Peltonen, M, Peters, A, Peykari, N, Pham, ST, Pitakaka, F, Piwonska, A, Piwonski, J, Plans-Rubió, P, Porta, M, Portegies, ML, Poustchi, H, Pradeepa, R, Price, JF, Punab, M, Qasrawi, RF, Qorbani, M, Radisauskas, R, Rahman, M, Raitakari, O, Rao, SR, Ramke, J, Ramos, R, Rampal, S, Rathmann, W, Redon, J, Reganit, PF, Rigo, F, Robinson, SM, Robitaille, C, Rodríguez-Artalejo, F, Rodriguez-Perez Mdel, C, Rodríguez-Villamizar, LA, Rojas-Martinez, R, Ronkainen, K, Rosengren, A, Rubinstein, A, Rui, O, Ruiz-Betancourt, BS, Russo Horimoto, RV, Rutkowski, M, Sabanayagam, C, Sachdev, HS, Saidi, O, Sakarya, S, Salanave, B, Salonen, JT, Salvetti, M, Sánchez-Abanto, J, Santos, D, dos Santos, RN, Santos, R, Saramies, JL, Sardinha, LB, Sarrafzadegan, N, Saum, KU, Scazufca, M, Schargrodsky, H, Scheidt-Nave, C, Sein, AA, Sharma, SK, Shaw, JE, Shibuya, K, Shin, Y, Shiri, R, Siantar, R, Sibai, AM, Simon, M, Simons, J, Simons, LA, Sjostrom, M, Slowikowska-Hilczer, J, Slusarczyk, P, Smeeth, L, Snijder, MB, So, HK, Sobngwi, E, Söderberg, S, Solfrizzi, V, Sonestedt, E, Soumare, A, Staessen, JA, Stathopoulou, MG, Steene-Johannessen, J, Stehle, P, Stein, AD, Stessman, J, Stöckl, D, Stokwiszewski, J, Stronks, K, Strufaldi, MW, Sun, CA, Sundström, J, Sung, YT, Suriyawongpaisal, P, Sy, RG, Tai, ES, Tamosiunas, A, Tang, L, Tarawneh, M, Tarqui-Mamani, CB, Taylor, A, Theobald, H, Thijs, L, Thuesen, BH, Tolonen, HK, Tolstrup, JS, Topbas, M, Torrent, M, Traissac, P, Trinh, OT, Tulloch-Reid, MK, Tuomainen, TP, Turley, ML, Tzourio, C, Ueda, P, Ukoli, FA, Ulmer, H, Uusitalo, HM, Valdivia, G, Valvi, D, van Rossem, L, van Valkengoed, IG, Vanderschueren, D, Vanuzzo, D, Vega, T, Velasquez-Melendez, G, Veronesi, G, Verschuren, WM, Verstraeten, R, Viet, L, Vioque, J, Virtanen, JK, Visvikis-Siest, S, Viswanathan, B, Vollenweider, P, Voutilainen, S, Vrijheid, M, Wade, AN, Wagner, A, Walton, J, Wan Mohamud, WN, Wang, F, Wang, MD, Wang, Q, Wang, YX, Wannamethee, SG, Weerasekera, D, Whincup, PH, Widhalm, K, Wiecek, A, Wijga, AH, Wilks, RJ, Willeit, J, Wilsgaard, T, Wojtyniak, B, Wong, TY, Woo, J, Woodward, M, Wu, FC, Wu, SL, Xu, H, Yan, W, Yang, X, Ye, X, Yoshihara, A, Younger-Coleman, NO, Zambon, S, Zargar, AH, Zdrojewski, T, Zhao, W, Zheng, Y, and Zuñiga Cisneros, J

Published
2016
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13. Single-Pill Combination with Three Antihypertensive Agents to Improve Blood Pressure Control in Hypertension: Focus on Olmesartan-Based Combinations

Author

Burnier, M., Redon, J., and Volpe, M.

Subjects
Humans, Aged, Antihypertensive Agents/therapeutic use, Blood Pressure, Olmesartan Medoxomil/therapeutic use, Drug Therapy, Combination, Hypertension, Amlodipine/therapeutic use, Hydrochlorothiazide/pharmacology, Hydrochlorothiazide/therapeutic use, Leukemia, Myeloid, Acute/drug therapy, Adherence, Blood pressure control, Diabetes, Elderly, Obesity, Olmesartan, Single pill combination
Abstract

Blood pressure control remains an unmet clinical need. Only about half of patients achieve their blood pressure (BP) targets and of these, the majority require combination and double or triple therapies. International guidelines recommend the association of drugs with complementary mechanisms of action and, in particular, the combination of renin-angiotensin system (RAS) inhibitors, calcium channel blockers (CCBs), and diuretics. Among the various angiotensin receptor blockers, olmesartan (OM) is available as a monotherapy and in dual and triple single-pill combinations (SPCs) with amlodipine (AML) and/or hydrochlorothiazide (HCTZ). Several phase III and IV studies, together with real-world studies, have demonstrated the additional benefits of combining OM either with AML or with HCTZ in terms of BP control and target BP achievements both in the general population and in special subgroups of hypertensive patients, such as the elderly, diabetic, chronic kidney disease or obese patients. Ambulatory BP monitoring studies assessing 24h BP have also demonstrated that dual, as well as triple, OM-based SPCs induce a more sustained and smoother BP reduction than placebo and monotherapy. Furthermore, triple OM-based SPC has been shown to improve therapeutic adherence in hypertensive patients compared to free combinations. The availability of OM combined with HCTZ, AML or both at different dosages makes it a valuable option to customize therapy based on the levels of BP and the clinical characteristics of hypertensive patients.

Published
2023

16. Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331 288 participants

Author

Danaei, G, Fahimi, S, Lu, Y, Zhou, B, Hajifathalian, K, Di Cesare, M, Lo, WC, Reis-Santos, B, Cowan, MJ, Shaw, JE, Bentham, J, Lin, JK, Bixby, H, Magliano, D, Bovet, P, Miranda, JJ, Khang, YH, Stevens, GA, Riley, LM, Ali, MK, Ezzati, M, Abdeen, ZA, Kadir, KA, Abu-Rmeileh, M, Acosta-Cazares, B, Aekplakorn, W, Aguilar-Salinas, CA, Ahmadvand, A, Al Nsour, M, Alkerwi, A, Amouyel, P, Andersen, LB, Anderssen, SA, Andrade, DS, Anjana, RM, Aounallah-Skhiri, H, Aris, T, Arlappa, N, Arveiler, D, Assah, FK, Avdicová, M, Balakrishna, N, Bandosz, P, Barbagallo, CM, Barceló, A, Batieha, AM, Baur, LA, Ben Romdhane, H, Bernabe-Ortiz, A, Bhargava, SK, Bi, Y, Bjerregaard, P, Björkelund, C, Blake, M, Blokstra, A, Bo, S, Boehm, BO, Boissonnet, CP, Brajkovich, I, Breckenkamp, J, Brewster, LM, Brian, GR, Bruno, G, Bugge, A, Cabrera de León, A, Can, G, Cândido, AP, Capuano, V, Carvalho, MJ, Casanueva, FF, Caserta, CA, Castetbon, K, Chamukuttan, S, Chaturvedi, N, Chen, CJ, Chen, F, Chen, S, Cheng, CY, Chetrit, A, Chiou, ST, Cho, Y, Chudek, J, Cifkova, R, Claessens, F, Concin, H, Cooper, C, Cooper, R, Costanzo, S, Cottel, D, Cowell, C, Crujeiras, AB, D'Arrigo, G, Dallongeville, J, Dankner, R, Dauchet, L, de Gaetano, G, De Henauw, S, Deepa, M, Dehghan, A, Dhana, K, Di Castelnuovo, AF, Djalalinia, S, Doua, K, Drygas, W, Du, Y, Egbagbe, EE, Eggertsen, R, El Ati, J, Elosua, R, Erasmus, RT, Erem, C, Ergor, G, Eriksen, L, Escobedo-de la Peña, J, Fall, CH, Farzadfar, F, Felix-Redondo, FJ, Ferguson, TS, Fernández-Bergés, D, Ferrari, M, Ferreccio, C, Finn, JD, Föger, B, Foo, LH, Fouad, HM, Francis, DK, Franco Mdo, C, Frontera, G, Furusawa, T, Gaciong, Z, Galbarczyk, A, Garnett, SP, Gaspoz, JM, Gasull, M, Gates, L, Geleijnse, JM, Ghasemain, A, Giampaoli, S, Gianfagna, F, Giovannelli, J, Gonzalez Gross, M, González Rivas, JP, Gorbea, MB, Gottrand, F, Grant, JF, Grodzicki, T, Grøntved, A, Gruden, G, Gu, D, Guan, OP, Guerrero, R, Guessous, I, Guimaraes, AL, Gutierrez, L, Hardy, R, Hari Kumar, R, Heidemann, C, Hihtaniemi, IT, Ho, SY, Ho, SC, Hofman, A, Horimoto, AR, Hormiga, CM, Horta, BL, Houti, L, Hussieni, AS, Huybrechts, I, Hwalla, N, Iacoviello, L, Iannone, AG, Ibrahim, MM, Ikeda, N, Ikram, MA, Irazola, VE, Islam, M, Iwasaki, M, Jacobs, JM, Jafar, T, Jasienska, G, Jiang, CQ, Jonas, JB, Joshi, P, Kafatos, A, Kalter-Leibovici, O, Kasaeian, A, Katz, J, Kaur, P, Kavousi, M, Kelishadi, R, Kengne, AP, Kersting, M, Khader, YS, Kiechl, S, Kim, J, Kiyohara, Y, Kolsteren, P, Korrovits, P, Koskinen, S, Kratzer, W, Kromhout, D, Kula, K, Kurjata, P, Kyobutungi, C, Lachat, C, Laid, Y, Lam, TH, Lanska, V, Lappas, G, Laxmaiah, A, Leclercq, C, Lee, J, Lehtimäki, T, Lekhraj, R, León-Muñoz, LM, Li, Y, Lim, WY, Lima-Costa, MF, Lin, HH, Lin, X, Lissner, L, Lorbeer, R, Lozano, JE, Lundqvist, A, Lytsy, P, Ma, G, Machado-Coelho, GL, Machi, S, Maggi, S, Makdisse, M, Mallikharjuna v, K, Manios, Y, Manzato, E, Margozzini, P, Marques-Vidal, P, Martorell, R, Masoodi, SR, Matsha, TE, Mbanya, JC, McFarlane, SR, McGarvey, ST, McLachlan, S, McNulty, BA, Mediene-Benchekor, S, Meirhaeghe, A, Menezes, AM, Merat, S, Meshram, II, Mi, J, Miquel, JF, Mohamed, MK, Mohammad, K, Mohan, V, Mohd Yusoff, MF, Møller, NC, Molnar, D, Mondo, CK, Moreno, LA, Morgan, K, Moschonis, G, Mossakowska, M, Mostafa, A, Mota, J, Muiesan, ML, Müller-Nurasyid, M, Mursu, J, Nagel, G, Námešná, J, Nang, EE, Nangia, VB, Navarrete-Muñoz, EM, Ndiaye, NC, Nervi, F, Nguyen, ND, Nieto-Martínez, RE, Alvarado, L, Ning, G, Ninomiya, T, Noale, M, Noto, D, Ochoa-Avilés, M, Oh, K, Onat, A, Osmond, C, Otero, JA, Palmieri, L, Panda-Jonas, S, Panza, F, Parsaeian, M, Peixoto, SV, Pereira, AC, Peters, A, Peykari, N, Pilav, A, Pitakaka, F, Piwonska, A, Piwonski, J, Plans-Rubió, P, Porta, M, Portegies, ML, Poustchi, H, Pradeepa, R, Price, JF, Punab, M, Qasrawi, RF, Qorbani, M, Raitakari, O, Ramachandra Rao, S, Ramachandran, A, Ramos, R, Rampal, S, Rathmann, W, Redon, J, Reganit, PF, Rigo, F, Robinson, SM, Robitaille, C, Rodríguez, LA, Rodríguez-Artalejo, F, del Cristo Rodriguez-Perez, M, Rojas-Martinez, R, Romaguera, D, Rosengren, A, Rubinstein, A, Rui, O, Ruiz-Betancourt, BS, Rutkowski, M, Sabanayagam, C, Sachdev, HS, Saidi, O, Sakarya, S, Salanave, B, Salonen, JT, Salvetti, M, Sánchez-Abanto, J, Santos, RN, Santos, R, Sardinha, LB, Scazufca, M, Schargrodsky, H, Scheidt-Nave, C, Shibuya, K, Shin, Y, Shiri, R, Siantar, R, Sibai, AM, Simon, M, Simons, J, Simons, LA, Sjostrom, M, Slowikowska-Hilczer, J, Slusarczyk, P, Smeeth, L, Snijder, MB, Solfrizzi, V, Sonestedt, E, Soumare, A, Staessen, JA, Steene-Johannessen, J, Stehle, P, Stein, AD, Stessman, J, Stöckl, D, Stokwiszewski, J, Strufaldi, MW, Sun, CA, Sundström, J, Suriyawongpaisal, P, Sy, RG, Tai, ES, Tarawneh, M, Tarqui-Mamani, CB, Thijs, L, Tolstrup, JS, Topbas, M, Torrent, M, Traissac, P, Trinh, OT, Tulloch-Reid, MK, Tuomainen, TP, Turley, ML, Tzourio, C, Ueda, P, Ukoli, FM, Ulmer, H, Valdivia, G, van Valkengoed, IG, Vanderschueren, D, Vanuzzo, D, Vega, T, Velasquez-Melendez, G, Veronesi, G, Verschuren, M, Vioque, J, Virtanen, J, Visvikis-Siest, S, Viswanathan, B, Vollenweider, P, Voutilainen, S, Wade, AN, Wagner, A, Walton, J, Mohamud, WN, Wang, MD, Wang, YX, Wannamethee, SG, Weerasekera, D, Whincup, PH, Widhalm, K, Wiecek, A, Wilks, RJ, Willeit, J, Wojtyniak, B, Wong, TY, Woo, J, Woodward, M, Wu, AG, Wu, FC, Wu, SL, Xu, H, Yang, X, Ye, X, Yoshihara, A, Younger-Coleman, NO, Zambon, S, Zargar, AH, Zdrojewski, T, Zhao, W, and Zheng, Y

Published
2015
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17. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries

Author

Linschoten, M, Uijl, A, Schut, A, Jakob, CEM, Romao, LR, Bell, RM, McFarlane, E, Stecher, M, Zondag, AGM, van Iperen, EPA, Hermans-van Ast, JF, Lea, NC, Schaap, J, Jewbali, LS, Smits, PC, Patel, RS, Aujayeb, A, van Smeden, M, Siebelink, HJ, Williams, S, Pilgram, L, Tieleman, RG, Williams, B, Asselbergs, FW, Al-Ali, AK, Al-Muhanna, FA, Al-Rubaish, AM, Al-Windy, NYY, Alkhalil, M, Almubarak, YA, Al Nafie, AN, Al Shahrani, M, Al Shehri, AM, Anning, C, Anthonio, RL, Badings, EA, Ball, C, Van Beek, EA, Ten Berg, JM, Von Bergwelt-Baildon, M, Bianco, M, Blagova, O, Bleijendaal, H, Bor, WL, Borgmann, S, van Boxem, AJM, van den Brink, FS, Bucciarelli-Ducci, C, Van Bussel, BCT, Byrom-Goulthorp, R, Captur, G, Caputo, M, Charlotte, N, vom Dahl, J, Dark, P, De Sutter, J, Degenhardt, C, Delsing, CE, Dolff, S, Dorman, HGR, Drost, JT, Eberwein, L, Emans, ME, Er, AG, Ferreira, JB, Forner, MJ, Friedrichs, A, Gabriel, L, Groenemeijer, BE, Groenendijk, AL, Gruener, B, Guggemos, W, Haerkens-Arends, HE, Hanses, F, Hedayat, B, Heigener, D, van der Heijden, DJ, Hellou, E, Hellwig, K, Henkens, MTHM, Hermanides, RS, Hermans, WRM, van Hessen, MWJ, Heymans, SRB, Hilt, AD, van der Horst, ICC, Hower, M, van Ierssel, SH, Isberner, N, Jensen, B, Kearney, MT, Kielstein, JT, Kietselaer, BLJH, Kochanek, M, Kolk, MZH, Koning, AMH, Kopylov, PY, Kuijper, AFM, Kwakkel-van, ERPJM, Lanznaster, J, van der Linden, MMJM, van der Lingen, ACJ, Linssen, GCM, Lomas, D, Maarse, M, Magdelijns, FJH, Magro, M, Markart, P, Martens, FMAC, Mazzilli, SG, McCann, GP, van der Meer, P, Meijs, MFL, Merle, U, Messiaen, P, Milovanovic, M, Monraats, PS, Montagna, L, Moriarty, A, Moss, AJ, Mosterd, A, Nadalin, S, Nattermann, J, Neufang, M, Nierop, PR, Offerhaus, JA, Van Ofwegen-Hanekamp, CEE, Parker, E, Persoon, AM, Piepel, C, Pinto, YM, Poorhosseini, H, Prasad, S, Raafs, AG, Raichle, C, Rauschning, D, Redon, J, Reidinga, AC, Ribeiro, MIA, Riedel, C, Rieg, S, Ripley, DP, Rommele, C, Rothfuss, K, Ruddel, J, Ruthrich, MM, Salah, R, Saneei, E, Saxena, M, Schellings, DAAM, Scholte, NTB, Schubert, J, Seelig, J, Shafiee, A, Shore, AC, Spinner, C, Stieglitz, S, Strauss, R, Sturkenboom, NH, Tessitore, E, Thomson, RJ, Timmermans, PJR, Tio, RA, Tjong, FVY, Tometten, L, Trauth, J, Van Craenenbroeck, EM, van Veen, HPAA, den Uil, CA, Vehreschild, MJGT, Veldhuis, L, Veneman, T, Verschure, DO, Voigt, I, Walter, L, vande Watering, DJ, de Vries, JK, vande Wal, RMA, Westendorp, ICD, Westendorp, PHM, Westhoff, T, Weytjens, C, Wierda, E, Wille, K, de With, K, Worm, M, Woudstra, P, Wu, KW, Zaal, R, Zaman, AG, van der Zee, PM, Zijlstra, LE, Alling, TE, Ahmed, R, Bayraktar-Verver, ECE, van Aken, K, Jimenes, Bermudez FJ, Biole, CA, Den Boer-Penning, P, Bontje, M, Bos, M, Bosch, L, Broekman, M, Broeyer, FJF, de Bruijn, EAW, Bruinsma, S, Cardoso, NM, Cosyns, B, Len, van Da DH, Dekimpe, E, Domange, J, van Doorn, JL, van DOorn, P, Dormal, F, Drost, IMJ, Dunnink, A, van Eck, JWM, Elshinawy, K, Gevers, RMM, Gognieva, DG, van der Graaf, M, Grangeon, S, Guclu, A, Habib, A, Haenen, NA, Hamilton, K, Handgraaf, S, Heidbuchel, H, Hendriks-van Woerden, M, Hessels-Linnemeijer, BM, Hosseini, K, Huisman, J, Jacobs, TC, Jansen, SE, Janssen, A, Jourdan, K, ten Kate, GL, van Kempen, MJ, Kievit, CM, Kleikers, P, Knufman, N, van der Kooi, SE, Koole, BAS, Koole, MAC, Kui, KK, Kuipers-Elferink, L, Lemoine, I, Lensink, E, van Marrewijk, V, Meijer, EJ, Melein, AJ, Mesitskaya, DF, van Nes, CPM, Paris, FMA, Perrelli, MG, Pieterse-Rots, A, Pisters, R, Polkerman, BC, van Poppel, A, Reinders, S, Reitsma, MJ, Ruiter, AH, Selder, JL, van der Sluis, A, Sousa, AIC, Tajdini, M, Sanchez, Tercedor L, Van de Heyning, CM, Vial, H, Vlieghe, E, Vonkeman, HE, Vreugdenhil, P, de Vries, TAC, Willems, AM, Wils, AM, Zoet-Nugteren, SK, Cardiovascular Centre (CVC), Restoring Organ Function by Means of Regenerative Medicine (REGENERATE), Cardiology, Intensive Care, RS: CAPHRI - R5 - Optimising Patient Care, MUMC+: MA Medische Staf IC (9), RS: Carim - H02 Cardiomyopathy, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - V04 Surgical intervention, MUMC+: MA Intensive Care (3), UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de cardiologie, CAPACITY-COVID Collaborative Consortium, LEOSS Study Group, Rheumatology, AII - Infectious diseases, AII - Inflammatory diseases, AMS - Musculoskeletal Health, AMS - Tissue Function & Regeneration, ACS - Heart failure & arrhythmias, General practice, Epidemiology and Data Science, Graduate School, Nuclear Medicine, and ACS - Atherosclerosis & ischemic syndromes

Subjects
Male, Cardiac & Cardiovascular Systems, Epidemiology, education, Medizin, Comorbidity, AMERICAN-COLLEGE, GUIDELINES, DIAGNOSIS, Cohort Studies, Risk Factors, MANAGEMENT, Humans, AcademicSubjects/MED00200, Hospital Mortality, Aged, Heart Failure, Science & Technology, SARS-CoV-2, COVID-19, ASSOCIATION, Cardiovascular disease, EUROPEAN-SOCIETY, Hospitalization, surgical procedures, operative, Editorial, Cardiovascular System & Cardiology, behavior and behavior mechanisms, HEART-FAILURE, Female, Patient registry, Human medicine, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, psychological phenomena and processes, TASK-FORCE
Abstract

Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66–75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n = 1545 vs. 15.9%; n = 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02–1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10–1.30; P Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization.

Published
2021

19. Renal outcomes and blood pressure patterns in diabetic and nondiabetic individuals at high cardiovascular risk

Author

Bohm, M, Schumacher, H, Teo, K, Lonn, E, Mahfoud, F, Emrich, I, Mancia, G, Redon, J, Schmieder, R, Sliwa, K, Lehrke, M, Marx, N, Weber, M, Williams, B, Yusuf, S, Mann, J, Bohm M., Schumacher H., Teo K. K., Lonn E. M., Mahfoud F., Emrich I., Mancia G., Redon J., Schmieder R. E., Sliwa K., Lehrke M., Marx N., Weber M. A., Williams B., Yusuf S., Mann J. F. E., Bohm, M, Schumacher, H, Teo, K, Lonn, E, Mahfoud, F, Emrich, I, Mancia, G, Redon, J, Schmieder, R, Sliwa, K, Lehrke, M, Marx, N, Weber, M, Williams, B, Yusuf, S, Mann, J, Bohm M., Schumacher H., Teo K. K., Lonn E. M., Mahfoud F., Emrich I., Mancia G., Redon J., Schmieder R. E., Sliwa K., Lehrke M., Marx N., Weber M. A., Williams B., Yusuf S., and Mann J. F. E.

Abstract

Background:Diabetes and hypertension are risk factors for renal and cardiovascular outcomes. Data on the association of achieved blood pressure (BP) with renal outcomes in patients with and without diabetes are sparse. We investigated the association of achieved SBP, DBP with renal outcomes and urinary albumin excretion (UAE) in people with vascular disease.Methods:In this pooled analysis, we assessed renal outcome data from high-risk patients aged 55 years or older with a history of cardiovascular disease, 70% of whom had hypertension, randomized to The Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial and to Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease trials investigating telmisartan, ramipril and their combination with a median follow-up of 56 months. Standardized office BP was measured every 6 months, estimated glomerular filtration rate (eGFR) and UAE at baseline, 2 years and study end. Associations of mean achieved BP on treatment were investigated on major renal outcomes including end-stage renal disease (ESRD), decline of eGFR by at least 40%, doubling of creatinine and the composites thereof and on UAE. Analyses were by Cox regression analysis, analysis of variance and Chi2-Test. Of 30 937 patients with complete data, 19 450 patients without and 11 487 with diabetes were enrolled between 1 December 2001 and 31 July 2003 and followed until 31 July 2008. Data were pooled as the outcomes for telmisartan 80 mg/day (n = 2903) or placebo (n = 2907) for Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease and ramipril 10 mg/day (n = 8407), telmisartan 80 mg/day (n = 8386) or the combination of both (n = 8334) were similar.Results:For both those with and without diabetes, the hazard ratios for the composites ESRD or doubling of serum creatinine (707 events overall) and ESRD or 40% eGFR loss (2371 events overall) reached a nadir at achieved SBP

Published
2021

20. Cardiovascular outcomes in patients at high cardiovascular risk with previous myocardial infarction or stroke

Author

Bohm, M, Schumacher, H, Teo, K, Lonn, E, Lauder, L, Mancia, G, Redon, J, Schmieder, R, Sliwa, K, Marx, N, Weber, M, Williams, B, Yusuf, S, Mann, J, Mahfoud, F, Bohm M., Schumacher H., Teo K. K., Lonn E. M., Lauder L., Mancia G., Redon J., Schmieder R. E., Sliwa K., Marx N., Weber M. A., Williams B., Yusuf S., Mann J. F. E., Mahfoud F., Bohm, M, Schumacher, H, Teo, K, Lonn, E, Lauder, L, Mancia, G, Redon, J, Schmieder, R, Sliwa, K, Marx, N, Weber, M, Williams, B, Yusuf, S, Mann, J, Mahfoud, F, Bohm M., Schumacher H., Teo K. K., Lonn E. M., Lauder L., Mancia G., Redon J., Schmieder R. E., Sliwa K., Marx N., Weber M. A., Williams B., Yusuf S., Mann J. F. E., and Mahfoud F.

Abstract

Background:Guidelines recommend to start blood pressure (BP)-lowering drugs also according to cardiovascular risk including history of cardiovascular events. We hypothesized that in patients with a history of myocardial infarction (MI), stroke, both or none of those, the index events predict the next event and have different SBP risk associations to different cardiovascular outcomes.Design and measurements:In this pooled posthoc, nonprespecified analysis, we assessed outcome data from high-risk patients aged 55 years or older with a history of cardiovascular events or proven cardiovascular disease, randomized to the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial and to Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease Trial investigating telmisartan, ramipril and their combination with a median follow-up of 56 months. Standardized office BP was measured every 6 months. Associations of mean achieved BP on treatment were investigated on MI, stroke and cardiovascular death. We identified patients with previous MI (N = 13 487), stroke (N = 4985), both (N = 1509) or none (N = 10 956) of these index events. Analyses were done by Cox regression, analysis of variance and Chi2-test. 30 937 patients with complete data were enrolled between 1 December 2001 and 31 July 2003, and followed until 31 July 2008. Data of both trials were pooled as the outcomes were similar.Results:Patients with MI as index event had a higher risk to experience a second MI [hazard ratio 1.42 (confidence interval (CI) 1.20-1.69), P < 0.0001] compared with patients with no events but no increased risk for a stroke as a next event [hazard ratio 0.95 (CI 0.73-1.23), n.s.]. The risk was roughly doubled when they had both, MI and stroke before [hazard ratio 2.07 (CI 1.58-2.71), P < 0.0001]. Patients with a stroke history had a roughly three-fold higher likelihood to experience a second stroke [hazard ratio 2.89 (CI 2.37-3.5

Published
2021

30. Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease

Author

Borghi, C, Agabiti-Rosei, E, Johnson, R, Kielstein, J, Lurbe, E, Mancia, G, Redon, J, Stack, A, Tsioufis, K, Borghi C., Agabiti-Rosei E., Johnson R. J., Kielstein J. T., Lurbe E., Mancia G., Redon J., Stack A. G., Tsioufis K. P., Borghi, C, Agabiti-Rosei, E, Johnson, R, Kielstein, J, Lurbe, E, Mancia, G, Redon, J, Stack, A, Tsioufis, K, Borghi C., Agabiti-Rosei E., Johnson R. J., Kielstein J. T., Lurbe E., Mancia G., Redon J., Stack A. G., and Tsioufis K. P.

Abstract

During the last century, there has been an increasing prevalence of hyperuricaemia noted in many populations. While uric acid is usually discussed in the context of gout, hyperuricaemia is also associated with hypertension, chronic kidney disease, hypertriglyceridaemia, obesity, atherosclerotic heart disease, metabolic syndrome, and type 2 diabetes. Here we review the connection between hyperuricaemia and cardiovascular, kidney and metabolic diseases. Contrary to the popular view that uric acid is an inert metabolite of purine metabolism, recent studies suggest serum uric acid may have a variety of pro-inflammatory, pro-oxidative and vasoconstrictive actions that may contribute to cardiometabolic diseases. Hyperuricaemia is a predictive factor for the development of hypertension, metabolic syndrome, type 2 diabetes, coronary artery disease, left ventricular hypertrophy, atrial fibrillation, myocardial infarction, stroke, heart failure and chronic kidney disease. Treatment with uric acid-lowering therapies has also been found to improve outcomes in patients with hypertension and kidney disease, in some but not all studies. In conclusion, uric acid is emerging as a potentially treatable risk factor for cardiometabolic diseases, and more clinical trials investigating the potential benefit of lowering serum uric acid are recommended in individuals with hyperuricaemia with and without deposition and concomitant hypertension, metabolic syndrome or chronic kidney disease.

Published
2020

31. Resting heart rate and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk analysis from the ONTARGET/TRANSCEND trials

Author

Bohm, M, Schumacher, H, Teo, K, Lonn, E, Mahfoud, F, Ukena, C, Mann, J, Mancia, G, Redon, J, Schmieder, R, Sliwa, K, Marx, N, Weber, M, Williams, B, Yusuf, S, Bohm M., Schumacher H., Teo K. K., Lonn E. M., Mahfoud F., Ukena C., Mann J. F. E., Mancia G., Redon J., Schmieder R. E., Sliwa K., Marx N., Weber M. A., Williams B., Yusuf S., Bohm, M, Schumacher, H, Teo, K, Lonn, E, Mahfoud, F, Ukena, C, Mann, J, Mancia, G, Redon, J, Schmieder, R, Sliwa, K, Marx, N, Weber, M, Williams, B, Yusuf, S, Bohm M., Schumacher H., Teo K. K., Lonn E. M., Mahfoud F., Ukena C., Mann J. F. E., Mancia G., Redon J., Schmieder R. E., Sliwa K., Marx N., Weber M. A., Williams B., and Yusuf S.

Abstract

Aims Resting heart rate (RHR) has been shown to be associated with cardiovascular outcomes in various conditions. It is unknown whether different levels of RHR and different associations with cardiovascular outcomes occur in patients with or without diabetes, because the impact of autonomic neuropathy on vascular vulnerability might be stronger in diabetes. Methods We examined 30 937 patients aged 55 years or older with a history of or at high risk for cardiovascular disease and and results after myocardial infarction, stroke, or with proven peripheral vascular disease from the ONTARGET and TRANSCEND trials investigating ramipril, telmisartan, and their combination followed for a median of 56 months. We analysed the association of mean achieved RHR on-treatment with the primary composite outcome of cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure, the components of the composite primary outcome, and all-cause death as continuous and categorical variables. Data were analysed by Cox regression analysis, ANOVA, and v2 test. These trials were registered with ClinicalTrials.gov.number NCT00153101. Patients were recruited from 733 centres in 40 countries between 1 December 2001 and 31 July 2008 (ONTARGET) and 1 November 2001 until 30 May 2004 (TRANSCEND). In total, 19 450 patients without diabetes and 11 487 patients with diabetes were stratified by mean RHR. Patients with diabetes compared to no diabetes had higher RHRs (71.8 ± 9.0 vs. 67.9 ± 8.8, P < 0.0001). In the categories of <60 bpm, 60 <_ 65 bpm, 65 <_ 70 bpm, 70 <_ 75 bpm, 75 <_ 80 bpm and >_80 bpm, non-diabetic patients had an increased hazard of the primary outcome with mean RHR of 75 <_ 80 bpm (adjusted hazard ratio [HR] 1.17 (1.01–1.36)) compared to RHR 60 <_ 65 bpm. For patients with in-trial RHR >_80 bpm the hazard ratios were highest (diabetes: 1.96 (1.64–2.34), no diabetes: 1.73 (1.49–2.00), For cardiovascular death hazards were also clea

Published
2020

32. Nutraceuticals and blood pressure control: A European Society of Hypertension position document

Author

Borghi, C, Tsioufis, K, Agabiti-Rosei, E, Burnier, M, Cicero, A, Clement, D, Coca, A, Desideri, G, Grassi, G, Lovic, D, Lurbe, E, Kahan, T, Kreutz, R, Jelakovic, B, Polonia, J, Redon, J, Van De Borne, P, Mancia, G, Borghi C., Tsioufis K., Agabiti-Rosei E., Burnier M., Cicero A. F. G., Clement D., Coca A., Desideri G., Grassi G., Lovic D., Lurbe E., Kahan T., Kreutz R., Jelakovic B., Polonia J., Redon J., Van De Borne P., Mancia G., Borghi, C, Tsioufis, K, Agabiti-Rosei, E, Burnier, M, Cicero, A, Clement, D, Coca, A, Desideri, G, Grassi, G, Lovic, D, Lurbe, E, Kahan, T, Kreutz, R, Jelakovic, B, Polonia, J, Redon, J, Van De Borne, P, Mancia, G, Borghi C., Tsioufis K., Agabiti-Rosei E., Burnier M., Cicero A. F. G., Clement D., Coca A., Desideri G., Grassi G., Lovic D., Lurbe E., Kahan T., Kreutz R., Jelakovic B., Polonia J., Redon J., Van De Borne P., and Mancia G.

Abstract

High-normal blood pressure (BP) is associated with an increased risk of cardiovascular disease, however the cost-benefit ratio of the use of antihypertensive treatment in these patients is not yet clear. Some dietary components and natural products seems to be able to significantly lower BP without significant side effects. The aim of this position document is to highlight which of these products have the most clinically significant antihypertensive action and wheter they could be suggested to patients with high-normal BP. Among foods, beetroot juice has the most covincing evidence of antihypertensive effect. Antioxidant-rich beverages (teas, coffee) could be considered. Among nutrients, magnesium, potassium and vitamin C supplements could improve BP. Among nonnutrient-nutraceuticals, soy isoflavones could be suggested in perimenopausal women, resveratrol in insulin-resistant patients, melatonin in study participants with night hypertension. In any case, the nutracutical approach has never to substitute the drug treatment, when needed.

Published
2020

33. The corona-virus disease 2019 pandemic compromised routine care for hypertension: a survey conducted among excellence centers of the European Society of Hypertension

Author

Weber, T, Januszewicz, A, Rosei, Ea, Tsioufis, K, Okorie, M, Stergiou, Gs, Volpe, M, Kreutz, R, Abraham, G, Azizi, M, Barna, I, Barroso, Wks, Brguljan, J, Chapman, N, De Backer, T, Dorobantu, M, Eckert, S, Gaciong, Z, Giannattasio, C, Glover, M, Gottsater, A, Grassos, C, Jarai, Z, Aguila, Fj, Kahan, T, Lopez-Sublet, M, Lovic, D, Lurbe, E, Makris, Tk, Mallamaci, F, Manolis, Aj, Marketou, M, Mazza, A, Mediavilla, Jd, Muiesan, Ml, Muxfeldt, Es, Nasr, E, Papadakis, I, Parounak, Z, Obregon, S, Oliveras, A, Pontremoli, R, Raev, D, Rajkumar, C, Redon, J, Robles, Nr, Rump, Lc, Sarzani, R, Sierra, C, Sirenko, Y, Stojanov, V, Tikkanen, I, Vaclavik, J, Veglio, F, Viigimaa, M, Webb, D, Zebekakis, P, and Zweiker, R

Subjects
medicine.medical_specialty, Ambulatory blood pressure, Coronavirus disease 2019 (COVID-19), Physiology, media_common.quotation_subject, Shutdown, Angiotensin-Converting Enzyme Inhibitors, Covid-19, blood pressure, hypertension routine care, renin-angiotensin system inhibitors, Angiotensin Receptor Antagonists, Antihypertensive Agents, Blood Pressure Monitoring, Ambulatory, COVID-19, Delivery of Health Care, Europe, Humans, Hypertension, Renin-Angiotensin System, SARS-CoV-2, Surveys and Questionnaires, Health Facilities, Health Services Accessibility, Pandemics, Virus diseases, Blood Pressure Monitoring, Excellence, Ambulatory, Pandemic, Internal Medicine, Medicine, Routine care, media_common, business.industry, Blood pressure, Emergency medicine, angiotensin receptor antagonists, angiotensin-converting enzyme inhibitors, antihypertensive agents, blood pressure monitoring, ambulatory, delivery of health care, humans, hypertension, renin-angiotensin system, surveys and questionnaires, health facilities, health services accessibility, pandemics, Cardiology and Cardiovascular Medicine, business
Abstract

Background: The Covid-19 pandemic caused a shutdown of healthcare systems in many countries. We explored the impact on hypertension care in the Excellence Center (EC) network of the European Society of Hypertension. Methods: We conducted a 17-question electronic survey among ECs. Results: Overall, 52 ECs from 20 European and three non-European countries participated, providing hypertension service for a median of 1500 hypertensive patients per center per year. Eighty-five percent of the ECs reported a shutdown lasting for 9 weeks (range 0–16). The number of patients treated per week decreased by 90%: from a median of 50 (range 10–400) before the pandemic to a median of 5.0 (range 0–150) during the pandemic (P < 0.0001). 60% of patients (range 0–100%) declared limited access to medical consultations. The majority of ECs (57%) could not provide 24-h ambulatory BP monitoring, whereas a median of 63% (range 0–100%) of the patients were regularly performing home BP monitoring. In the majority (75%) of the ECs, hypertension service returned to normal after the first wave of the pandemic. In 66% of the ECs, the physicians received many questions regarding the use of renin–angiotensin system (RAS) blockers. Stopping RAS-blocker therapy (in a few patients) either by patients or physicians was reported in 27 and 36.5% of the ECs. Conclusion: Patient care in hypertension ECs was compromised during the Covid-19-related shutdown. These data highlight the necessity to develop new strategies for hypertension care including virtual clinics to maintain services during challenging times.

Published
2021

34. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries

Author

Linschoten, M., Uijl, A., Schut, A., Jakob, C. E. M., Romao, L. R., Bell, R. M., McFarlane, E., Stecher, M., Zondag, A. G. M., van Iperen, E. P. A., Hermans-van Ast, J. F., Lea, N. C., Schaap, J., Jewbali, L. S., Smits, P. C., Patel, R. S., Aujayeb, A., van Smeden, M., Siebelink, H. J., Williams, S., Pilgram, L., Tieleman, R. G., Williams, B., Asselbergs, F. W., Al-Ali, A. K., Al-Muhanna, F. A., Al-Rubaish, A. M., Al-Windy, N. Y. Y., Alkhalil, M., Almubarak, Y. A., Al Nafie, A. N., Al Shahrani, M., Al Shehri, A. M., Anning, C., Anthonio, R. L., Badings, E. A., Ball, C., Van Beek, E. A., Ten Berg, J. M., Von Bergwelt-Baildon, M., Bianco, M., Blagova, O., V, Bleijendaal, H., Bor, W. L., Borgmann, S., van Boxem, A. J. M., van den Brink, F. S., Bucciarelli-Ducci, C., Van Bussel, B. C. T., Byrom-Goulthorp, R., Captur, G., Caputo, M., Charlotte, N., vom Dahl, J., Dark, P., De Sutter, J., Degenhardt, C., Delsing, C. E., Dolff, S., Dorman, H. G. R., Drost, J. T., Eberwein, L., Emans, M. E., Er, A. G., Ferreira, J. B., Forner, M. J., Friedrichs, A., Gabriel, L., Groenemeijer, B. E., Groenendijk, A. L., Gruener, B., Guggemos, W., Haerkens-Arends, H. E., Hanses, F., Hedayat, B., Heigener, D., van der Heijden, D. J., Hellou, E., Hellwig, K., Henkens, M. T. H. M., Hermanides, R. S., Hermans, W. R. M., van Hessen, M. W. J., Heymans, S. R. B., Hilt, A. D., van der Horst, I. C. C., Hower, M., van Ierssel, S. H., Isberner, N., Jensen, B., Kearney, M. T., Kielstein, J. T., Kietselaer, B. L. J. H., Kochanek, M., Kolk, M. Z. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van, E. R. P. J. M., Lanznaster, J., van der Linden, M. M. J. M., van der Lingen, A. C. J., Linssen, G. C. M., Lomas, D., Maarse, M., Magdelijns, F. J. H., Magro, M., Markart, P., Martens, F. M. A. C., Mazzilli, S. G., McCann, G. P., van der Meer, P., Meijs, M. F. L., Merle, U., Messiaen, P., Milovanovic, M., Monraats, P. S., Montagna, L., Moriarty, A., Moss, A. J., Mosterd, A., Nadalin, S., Nattermann, J., Neufang, M., Nierop, P. R., Offerhaus, J. A., Van Ofwegen-Hanekamp, C. E. E., Parker, E., Persoon, A. M., Piepel, C., Pinto, Y. M., Poorhosseini, H., Prasad, S., Raafs, A. G., Raichle, C., Rauschning, D., Redon, J., Reidinga, A. C., Ribeiro, M. I. A., Riedel, C., Rieg, S., Ripley, D. P., Rommele, C., Rothfuss, K., Ruddel, J., Ruthrich, M. M., Salah, R., Saneei, E., Saxena, M., Schellings, D. A. A. M., Scholte, N. T. B., Schubert, J., Seelig, J., Shafiee, A., Shore, A. C., Spinner, C., Stieglitz, S., Strauss, R., Sturkenboom, N. H., Tessitore, E., Thomson, R. J., Timmermans, P. J. R., Tio, R. A., Tjong, F. V. Y., Tometten, L., Trauth, J., Van Craenenbroeck, E. M., van Veen, H. P. A. A., den Uil, C. A., Vehreschild, M. J. G. T., Veldhuis, L., I, Veneman, T., Verschure, D. O., Voigt, I, Walter, L., vande Watering, D. J., de Vries, J. K., vande Wal, R. M. A., Westendorp, I. C. D., Westendorp, P. H. M., Westhoff, T., Weytjens, C., Wierda, E., Wille, K., de With, K., Worm, M., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Zijlstra, L. E., Alling, T. E., Ahmed, R., Bayraktar-Verver, E. C. E., van Aken, K., Jimenes, Bermudez F. J., Biole, C. A., Den Boer-Penning, P., Bontje, M., Bos, M., Bosch, L., Broekman, M., Broeyer, F. J. F., de Bruijn, E. A. W., Bruinsma, S., Cardoso, N. M., Cosyns, B., Len, van Da D. H., Dekimpe, E., Domange, J., van Doorn, J. L., van DOorn, P., Dormal, F., Drost, I. M. J., Dunnink, A., van Eck, J. W. M., Elshinawy, K., Gevers, R. M. M., Gognieva, D. G., van der Graaf, M., Grangeon, S., Guclu, A., Habib, A., Haenen, N. A., Hamilton, K., Handgraaf, S., Heidbuchel, H., Hendriks-van Woerden, M., Hessels-Linnemeijer, B. M., Hosseini, K., Huisman, J., Jacobs, T. C., Jansen, S. E., Janssen, A., Jourdan, K., ten Kate, G. L., van Kempen, M. J., Kievit, C. M., Kleikers, P., Knufman, N., van der Kooi, S. E., Koole, B. A. S., Koole, M. A. C., Kui, K. K., Kuipers-Elferink, L., Lemoine, I, Lensink, E., van Marrewijk, V, Meijer, E. J., Melein, A. J., Mesitskaya, D. F., van Nes, C. P. M., Paris, F. M. A., Perrelli, M. G., Pieterse-Rots, A., Pisters, R., Polkerman, B. C., van Poppel, A., Reinders, S., Reitsma, M. J., Ruiter, A. H., Selder, J. L., van der Sluis, A., Sousa, A. I. C., Tajdini, M., Sanchez, Tercedor L., Van de Heyning, C. M., Vial, H., Vlieghe, E., Vonkeman, H. E., Vreugdenhil, P., de Vries, T. A. C., Willems, A. M., Wils, A. M., Zoet-Nugteren, S. K., Linschoten, M., Uijl, A., Schut, A., Jakob, C. E. M., Romao, L. R., Bell, R. M., McFarlane, E., Stecher, M., Zondag, A. G. M., van Iperen, E. P. A., Hermans-van Ast, J. F., Lea, N. C., Schaap, J., Jewbali, L. S., Smits, P. C., Patel, R. S., Aujayeb, A., van Smeden, M., Siebelink, H. J., Williams, S., Pilgram, L., Tieleman, R. G., Williams, B., Asselbergs, F. W., Al-Ali, A. K., Al-Muhanna, F. A., Al-Rubaish, A. M., Al-Windy, N. Y. Y., Alkhalil, M., Almubarak, Y. A., Al Nafie, A. N., Al Shahrani, M., Al Shehri, A. M., Anning, C., Anthonio, R. L., Badings, E. A., Ball, C., Van Beek, E. A., Ten Berg, J. M., Von Bergwelt-Baildon, M., Bianco, M., Blagova, O., V, Bleijendaal, H., Bor, W. L., Borgmann, S., van Boxem, A. J. M., van den Brink, F. S., Bucciarelli-Ducci, C., Van Bussel, B. C. T., Byrom-Goulthorp, R., Captur, G., Caputo, M., Charlotte, N., vom Dahl, J., Dark, P., De Sutter, J., Degenhardt, C., Delsing, C. E., Dolff, S., Dorman, H. G. R., Drost, J. T., Eberwein, L., Emans, M. E., Er, A. G., Ferreira, J. B., Forner, M. J., Friedrichs, A., Gabriel, L., Groenemeijer, B. E., Groenendijk, A. L., Gruener, B., Guggemos, W., Haerkens-Arends, H. E., Hanses, F., Hedayat, B., Heigener, D., van der Heijden, D. J., Hellou, E., Hellwig, K., Henkens, M. T. H. M., Hermanides, R. S., Hermans, W. R. M., van Hessen, M. W. J., Heymans, S. R. B., Hilt, A. D., van der Horst, I. C. C., Hower, M., van Ierssel, S. H., Isberner, N., Jensen, B., Kearney, M. T., Kielstein, J. T., Kietselaer, B. L. J. H., Kochanek, M., Kolk, M. Z. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van, E. R. P. J. M., Lanznaster, J., van der Linden, M. M. J. M., van der Lingen, A. C. J., Linssen, G. C. M., Lomas, D., Maarse, M., Magdelijns, F. J. H., Magro, M., Markart, P., Martens, F. M. A. C., Mazzilli, S. G., McCann, G. P., van der Meer, P., Meijs, M. F. L., Merle, U., Messiaen, P., Milovanovic, M., Monraats, P. S., Montagna, L., Moriarty, A., Moss, A. J., Mosterd, A., Nadalin, S., Nattermann, J., Neufang, M., Nierop, P. R., Offerhaus, J. A., Van Ofwegen-Hanekamp, C. E. E., Parker, E., Persoon, A. M., Piepel, C., Pinto, Y. M., Poorhosseini, H., Prasad, S., Raafs, A. G., Raichle, C., Rauschning, D., Redon, J., Reidinga, A. C., Ribeiro, M. I. A., Riedel, C., Rieg, S., Ripley, D. P., Rommele, C., Rothfuss, K., Ruddel, J., Ruthrich, M. M., Salah, R., Saneei, E., Saxena, M., Schellings, D. A. A. M., Scholte, N. T. B., Schubert, J., Seelig, J., Shafiee, A., Shore, A. C., Spinner, C., Stieglitz, S., Strauss, R., Sturkenboom, N. H., Tessitore, E., Thomson, R. J., Timmermans, P. J. R., Tio, R. A., Tjong, F. V. Y., Tometten, L., Trauth, J., Van Craenenbroeck, E. M., van Veen, H. P. A. A., den Uil, C. A., Vehreschild, M. J. G. T., Veldhuis, L., I, Veneman, T., Verschure, D. O., Voigt, I, Walter, L., vande Watering, D. J., de Vries, J. K., vande Wal, R. M. A., Westendorp, I. C. D., Westendorp, P. H. M., Westhoff, T., Weytjens, C., Wierda, E., Wille, K., de With, K., Worm, M., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Zijlstra, L. E., Alling, T. E., Ahmed, R., Bayraktar-Verver, E. C. E., van Aken, K., Jimenes, Bermudez F. J., Biole, C. A., Den Boer-Penning, P., Bontje, M., Bos, M., Bosch, L., Broekman, M., Broeyer, F. J. F., de Bruijn, E. A. W., Bruinsma, S., Cardoso, N. M., Cosyns, B., Len, van Da D. H., Dekimpe, E., Domange, J., van Doorn, J. L., van DOorn, P., Dormal, F., Drost, I. M. J., Dunnink, A., van Eck, J. W. M., Elshinawy, K., Gevers, R. M. M., Gognieva, D. G., van der Graaf, M., Grangeon, S., Guclu, A., Habib, A., Haenen, N. A., Hamilton, K., Handgraaf, S., Heidbuchel, H., Hendriks-van Woerden, M., Hessels-Linnemeijer, B. M., Hosseini, K., Huisman, J., Jacobs, T. C., Jansen, S. E., Janssen, A., Jourdan, K., ten Kate, G. L., van Kempen, M. J., Kievit, C. M., Kleikers, P., Knufman, N., van der Kooi, S. E., Koole, B. A. S., Koole, M. A. C., Kui, K. K., Kuipers-Elferink, L., Lemoine, I, Lensink, E., van Marrewijk, V, Meijer, E. J., Melein, A. J., Mesitskaya, D. F., van Nes, C. P. M., Paris, F. M. A., Perrelli, M. G., Pieterse-Rots, A., Pisters, R., Polkerman, B. C., van Poppel, A., Reinders, S., Reitsma, M. J., Ruiter, A. H., Selder, J. L., van der Sluis, A., Sousa, A. I. C., Tajdini, M., Sanchez, Tercedor L., Van de Heyning, C. M., Vial, H., Vlieghe, E., Vonkeman, H. E., Vreugdenhil, P., de Vries, T. A. C., Willems, A. M., Wils, A. M., and Zoet-Nugteren, S. K.

Abstract

Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n= 1545 vs. 15.9%; n= 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P <0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization. [GRAPHICS] .

Published
2022

35. Dual endothelin antagonist aprocitentan for resistant hypertension (PRECISION): a multicentre, blinded, randomised, parallel-group, phase 3 trial

Author

Schlaich, M, Bellet, M, Weber, M, Danaietash, P, Bakris, G, Flack, J, Dreier, R, Sassi-Sayadi, M, Haskell, L, Narkiewicz, K, Wang, J, Reid, C, Katz, I, Ajani, A, Biswas, S, Esler, M, Elder, G, Roger, S, Colquhoun, D, Mooney, J, De Backer, T, Persu, A, Chaumont, M, Krzesinski, J, Vanabsche, T, Girard, G, Pliamm, L, Schiffrin, E, Merali, F, Dresser, G, Vallee, M, Jolly, S, Chow, S, Mu, J, Yu, J, Yuan, H, Feng, Y, Zhang, X, Xie, J, Lin, L, Soucek, M, Widimsky, J, Cifkova, R, Vaclavik, J, Ullrych, M, Lukac, M, Rychlik, I, Guldager Lauridsen, T, Kantola, I, Taurio, J, Ukkola, O, Ormezzano, O, Gosse, P, Azizi, M, Courand, P, Delsart, P, Tartiere, J, Mahfoud, F, Schmieder, R, Stegbauer, J, Lurz, P, Koziolek, M, Ott, C, Toursarkissian, N, Tsioufis, K, Kyfnidis, K, Manolis, A, Patsilinakos, S, Zebekakis, P, Karavidas, A, Denes, P, Bezzegh, K, Zsom, M, Kovacs, L, Sharabi, Y, Elias, M, Sukholutsky, I, Yosefy, C, Kenis, I, Atar, S, Volpe, M, Lorenza, M, Taddei, S, Grassi, G, Veglio, F, Son, J, Kim, J, Park, J, Lee, C, Lee, H, Raugaliene, R, Marcinkeviciene, J, Kavaliauskiene, R, Deinum, J, Kroon, A, van den Born, B, Januszewicz, A, Tykarski, A, Walczewska, J, Gaciong, Z, Wiecek, A, Chrostowska, M, Kleinrok, A, Krekora, J, Kania, G, Podrazka-Szczepaniak, A, Golawski, C, Podziewski, M, Kaczmarek, B, Skoczylas, G, Wilkolaski, A, Wozniak, I, Janik-Palazzolo, M, Rewerska, B, Konradi, A, Shvarts, Y, Pecherina, T, Nikolaev, K, Liudmila, G, Orlikova, O, Mordovin, V, Petrochenkova, N, Kamalov, G, Kosmacheva, E, Tyrenko, V, Gorbunov, V, Obrezan, A, Supryadkina, T, Ler, I, Kotenko, O, Kuzin, A, Martinez, F, Redon, J, Oliveras, A, Beltran Romero, L, Shatylo, V, Rudenko, L, Bazylevych, A, Rudyk, Y, Karpenko, O, Stanislavchuk, M, Tseluyko, V, Kushnir, M, Asanov, E, Sirenko, Y, Yagensky, A, Collier, D, Gupta, P, Webb, D, Macleod, M, Mclay, J, Peace, A, Arora, S, Buchanan, P, Harris, R, Degarmo, R, Guillen, M, Karns, A, Neutel, J, Paliwal, Y, Pettis, K, Toth, P, Wayne, J, Butcher, B, Diller, P, Oparil, S, Calhoun, D, Brautigam, D, Goldman, J, Rashidi, A, Aslam, N, Haley, W, Andrawis, N, Lang, B, Miller, R, Powell, J, Dewhurst, R, Pritchard, J, Khanna, D, Tang, D, Gabra, N, Jones, C, Scott, C, Luna, B, Mussaji, M, Bhagwat, R, Bauer, M, Mcginty, J, Nambiar, R, Sangrigoli, R, Ross Davis, W, Eaves, W, Mcgrew, F, Awad, A, Bolster, E, Scott, D, Kalirao, P, Dabel, P, Calhoun, W, Gouge, S, Warren, M, Lawrence, M, Jamal, A, El-Shahawy, M, Mercado, C, Kumar, J, Velasquez-Mieyer, P, Busch, R, Lewis, T, Rich, L, Schlaich, Markus P, Bellet, Marc, Weber, Michael A, Danaietash, Parisa, Bakris, George L, Flack, John M, Dreier, Roland F, Sassi-Sayadi, Mouna, Haskell, Lloyd P, Narkiewicz, Krzysztof, Wang, Ji-Guang, Reid, Christopher, Schlaich, Markus, Katz, Ivor, Ajani, Andrew, Biswas, Sinjini, Esler, Murray, Elder, Grahame, Roger, Simon, Colquhoun, David, Mooney, John, De Backer, Tine, Persu, Alexandre, Chaumont, Martin, Krzesinski, Jean-Marie, Vanabsche, Thomas, Girard, Ginette, Pliamm, Lew, Schiffrin, Ernesto, Merali, Fatima, Dresser, George, Vallee, Michel, Jolly, Shivinder, Chow, Stephen, Wang, Jiguang, Mu, Jianjun, Yu, Jing, Yuan, Hong, Feng, Yingqing, Zhang, Xin, Xie, Jianhong, Lin, Ling, Soucek, Miroslav, Widimsky, Jiri, Cifkova, Renata, Vaclavik, Jan, Ullrych, Martin, Lukac, Martin, Rychlik, Ivan, Guldager Lauridsen, Thomas, Kantola, Ilkka, Taurio, Jyrki, Ukkola, Olavi, Ormezzano, Olivier, Gosse, Philippe, Azizi, Michel, Courand, Pierre-Yves, Delsart, Pascal, Tartiere, Jean Michel, Mahfoud, Felix, Schmieder, Roland, Stegbauer, Johannes, Lurz, Philipp, Koziolek, Michael, Ott, Christian, Toursarkissian, Nicole, Tsioufis, Konstantinos, Kyfnidis, Konstantinos, Manolis, Athanasios, Patsilinakos, Sotirios, Zebekakis, Pantelis, Karavidas, Apostolos, Denes, Pall, Bezzegh, Katalin, Zsom, Marianna, Kovacs, Laszlo, Sharabi, Yehonatan, Elias, Mazen, Sukholutsky, Ivetta, Yosefy, Chaim, Kenis, Irina, Atar, Shaul, Volpe, Massimo, Lorenza, Muiesan Maria, Taddei, Stefano, Grassi, Guido, Veglio, Franco, Son, Jung Woo, Kim, Jang-Young, Park, Joong-Il, Lee, Chang Hoon, Lee, Hae-Young, Raugaliene, Rasa, Marcinkeviciene, Jolanta Elena, Kavaliauskiene, Roma, Deinum, Jaap, Kroon, Abraham, van den Born, Bert-Jan, Januszewicz, Andrzej, Tykarski, Andrzej, Walczewska, Jolanta, Gaciong, Zbigniew, Wiecek, Andrzej, Chrostowska, Marzena, Kleinrok, Andrzej, Krekora, Jan, Kania, Grzegorz, Podrazka-Szczepaniak, Anna, Golawski, Cezary, Podziewski, Maciej, Kaczmarek, Barbara, Skoczylas, Grzegorz, Wilkolaski, Andrzej, Wozniak, Iwona, Janik-Palazzolo, Marzena, Rewerska, Barbara, Konradi, Alexandra, Shvarts, Yuriy, Pecherina, Tamara, Nikolaev, Konstantin, Liudmila, Gapon, Orlikova, Olga, Mordovin, Viktor, Petrochenkova, Natalia, Kamalov, Gadel, Kosmacheva, Elena, Tyrenko, Vadim, Gorbunov, Vladimir, Obrezan, Andrey, Supryadkina, Tatiana, Ler, Irina, Kotenko, Oleg, Kuzin, Anatoly, Martinez, Fernando, Redon, Josep, Oliveras, Anna, Beltran Romero, Luis, Shatylo, Valerii, Rudenko, Leonid, Bazylevych, Andriiy, Rudyk, Yurii, Karpenko, Oleksandr, Stanislavchuk, Mykola, Tseluyko, Vira, Kushnir, Mykola, Asanov, Ervin, Sirenko, Yuriy, Yagensky, Andriy, Collier, David, Gupta, Pankaj, Webb, David, MacLeod, Mary, McLay, James, Peace, Aaron, Arora, Samir, Buchanan, Patricia, Harris, Robert, Degarmo, Ronald, Guillen, Mario, Karns, Adam, Neutel, Joel, Paliwal, Yogesh, Pettis, Karlton, Toth, Phillip D., Wayne, Jeffrey M., Butcher, Bain, Diller, Phillip M., Oparil, Suzanne, Calhoun, David, Brautigam, Donald, Flack, John, Goldman, Jesse M., Rashidi, Arash, Aslam, Nabeel, Haley, William, Andrawis, Nabil, Lang, Brian, Miller, Randy, Powell, James, Dewhurst, Robert, Pritchard, James, Khanna, Dinesh, Tang, Dennis, Gabra, Nashwa, Park, Jean, Jones, Conigliaro, Scott, Cranford, Luna, Blanca, Mussaji, Murtaza, Bhagwat, Ravi, Bauer, Michael, McGinty, John, Nambiar, Rajesh, Sangrigoli, Renee, Ross Davis, William, Eaves, William, McGrew, Frank, Awad, Ahmed, Bolster, Eric, Scott, David, Kalirao, Paramjit, Dabel, Pascal, Calhoun, Wesley, Gouge, Steven, Warren, Mark, Lawrence, Mary Katherine, Jamal, Aamir, El-Shahawy, Mohamed, Mercado, Carlos, Kumar, Jayant, Velasquez-Mieyer, Pedro, Busch, Robert, Lewis, Todd, Rich, Lisa, Schlaich, M, Bellet, M, Weber, M, Danaietash, P, Bakris, G, Flack, J, Dreier, R, Sassi-Sayadi, M, Haskell, L, Narkiewicz, K, Wang, J, Reid, C, Katz, I, Ajani, A, Biswas, S, Esler, M, Elder, G, Roger, S, Colquhoun, D, Mooney, J, De Backer, T, Persu, A, Chaumont, M, Krzesinski, J, Vanabsche, T, Girard, G, Pliamm, L, Schiffrin, E, Merali, F, Dresser, G, Vallee, M, Jolly, S, Chow, S, Mu, J, Yu, J, Yuan, H, Feng, Y, Zhang, X, Xie, J, Lin, L, Soucek, M, Widimsky, J, Cifkova, R, Vaclavik, J, Ullrych, M, Lukac, M, Rychlik, I, Guldager Lauridsen, T, Kantola, I, Taurio, J, Ukkola, O, Ormezzano, O, Gosse, P, Azizi, M, Courand, P, Delsart, P, Tartiere, J, Mahfoud, F, Schmieder, R, Stegbauer, J, Lurz, P, Koziolek, M, Ott, C, Toursarkissian, N, Tsioufis, K, Kyfnidis, K, Manolis, A, Patsilinakos, S, Zebekakis, P, Karavidas, A, Denes, P, Bezzegh, K, Zsom, M, Kovacs, L, Sharabi, Y, Elias, M, Sukholutsky, I, Yosefy, C, Kenis, I, Atar, S, Volpe, M, Lorenza, M, Taddei, S, Grassi, G, Veglio, F, Son, J, Kim, J, Park, J, Lee, C, Lee, H, Raugaliene, R, Marcinkeviciene, J, Kavaliauskiene, R, Deinum, J, Kroon, A, van den Born, B, Januszewicz, A, Tykarski, A, Walczewska, J, Gaciong, Z, Wiecek, A, Chrostowska, M, Kleinrok, A, Krekora, J, Kania, G, Podrazka-Szczepaniak, A, Golawski, C, Podziewski, M, Kaczmarek, B, Skoczylas, G, Wilkolaski, A, Wozniak, I, Janik-Palazzolo, M, Rewerska, B, Konradi, A, Shvarts, Y, Pecherina, T, Nikolaev, K, Liudmila, G, Orlikova, O, Mordovin, V, Petrochenkova, N, Kamalov, G, Kosmacheva, E, Tyrenko, V, Gorbunov, V, Obrezan, A, Supryadkina, T, Ler, I, Kotenko, O, Kuzin, A, Martinez, F, Redon, J, Oliveras, A, Beltran Romero, L, Shatylo, V, Rudenko, L, Bazylevych, A, Rudyk, Y, Karpenko, O, Stanislavchuk, M, Tseluyko, V, Kushnir, M, Asanov, E, Sirenko, Y, Yagensky, A, Collier, D, Gupta, P, Webb, D, Macleod, M, Mclay, J, Peace, A, Arora, S, Buchanan, P, Harris, R, Degarmo, R, Guillen, M, Karns, A, Neutel, J, Paliwal, Y, Pettis, K, Toth, P, Wayne, J, Butcher, B, Diller, P, Oparil, S, Calhoun, D, Brautigam, D, Goldman, J, Rashidi, A, Aslam, N, Haley, W, Andrawis, N, Lang, B, Miller, R, Powell, J, Dewhurst, R, Pritchard, J, Khanna, D, Tang, D, Gabra, N, Jones, C, Scott, C, Luna, B, Mussaji, M, Bhagwat, R, Bauer, M, Mcginty, J, Nambiar, R, Sangrigoli, R, Ross Davis, W, Eaves, W, Mcgrew, F, Awad, A, Bolster, E, Scott, D, Kalirao, P, Dabel, P, Calhoun, W, Gouge, S, Warren, M, Lawrence, M, Jamal, A, El-Shahawy, M, Mercado, C, Kumar, J, Velasquez-Mieyer, P, Busch, R, Lewis, T, Rich, L, Schlaich, Markus P, Bellet, Marc, Weber, Michael A, Danaietash, Parisa, Bakris, George L, Flack, John M, Dreier, Roland F, Sassi-Sayadi, Mouna, Haskell, Lloyd P, Narkiewicz, Krzysztof, Wang, Ji-Guang, Reid, Christopher, Schlaich, Markus, Katz, Ivor, Ajani, Andrew, Biswas, Sinjini, Esler, Murray, Elder, Grahame, Roger, Simon, Colquhoun, David, Mooney, John, De Backer, Tine, Persu, Alexandre, Chaumont, Martin, Krzesinski, Jean-Marie, Vanabsche, Thomas, Girard, Ginette, Pliamm, Lew, Schiffrin, Ernesto, Merali, Fatima, Dresser, George, Vallee, Michel, Jolly, Shivinder, Chow, Stephen, Wang, Jiguang, Mu, Jianjun, Yu, Jing, Yuan, Hong, Feng, Yingqing, Zhang, Xin, Xie, Jianhong, Lin, Ling, Soucek, Miroslav, Widimsky, Jiri, Cifkova, Renata, Vaclavik, Jan, Ullrych, Martin, Lukac, Martin, Rychlik, Ivan, Guldager Lauridsen, Thomas, Kantola, Ilkka, Taurio, Jyrki, Ukkola, Olavi, Ormezzano, Olivier, Gosse, Philippe, Azizi, Michel, Courand, Pierre-Yves, Delsart, Pascal, Tartiere, Jean Michel, Mahfoud, Felix, Schmieder, Roland, Stegbauer, Johannes, Lurz, Philipp, Koziolek, Michael, Ott, Christian, Toursarkissian, Nicole, Tsioufis, Konstantinos, Kyfnidis, Konstantinos, Manolis, Athanasios, Patsilinakos, Sotirios, Zebekakis, Pantelis, Karavidas, Apostolos, Denes, Pall, Bezzegh, Katalin, Zsom, Marianna, Kovacs, Laszlo, Sharabi, Yehonatan, Elias, Mazen, Sukholutsky, Ivetta, Yosefy, Chaim, Kenis, Irina, Atar, Shaul, Volpe, Massimo, Lorenza, Muiesan Maria, Taddei, Stefano, Grassi, Guido, Veglio, Franco, Son, Jung Woo, Kim, Jang-Young, Park, Joong-Il, Lee, Chang Hoon, Lee, Hae-Young, Raugaliene, Rasa, Marcinkeviciene, Jolanta Elena, Kavaliauskiene, Roma, Deinum, Jaap, Kroon, Abraham, van den Born, Bert-Jan, Januszewicz, Andrzej, Tykarski, Andrzej, Walczewska, Jolanta, Gaciong, Zbigniew, Wiecek, Andrzej, Chrostowska, Marzena, Kleinrok, Andrzej, Krekora, Jan, Kania, Grzegorz, Podrazka-Szczepaniak, Anna, Golawski, Cezary, Podziewski, Maciej, Kaczmarek, Barbara, Skoczylas, Grzegorz, Wilkolaski, Andrzej, Wozniak, Iwona, Janik-Palazzolo, Marzena, Rewerska, Barbara, Konradi, Alexandra, Shvarts, Yuriy, Pecherina, Tamara, Nikolaev, Konstantin, Liudmila, Gapon, Orlikova, Olga, Mordovin, Viktor, Petrochenkova, Natalia, Kamalov, Gadel, Kosmacheva, Elena, Tyrenko, Vadim, Gorbunov, Vladimir, Obrezan, Andrey, Supryadkina, Tatiana, Ler, Irina, Kotenko, Oleg, Kuzin, Anatoly, Martinez, Fernando, Redon, Josep, Oliveras, Anna, Beltran Romero, Luis, Shatylo, Valerii, Rudenko, Leonid, Bazylevych, Andriiy, Rudyk, Yurii, Karpenko, Oleksandr, Stanislavchuk, Mykola, Tseluyko, Vira, Kushnir, Mykola, Asanov, Ervin, Sirenko, Yuriy, Yagensky, Andriy, Collier, David, Gupta, Pankaj, Webb, David, MacLeod, Mary, McLay, James, Peace, Aaron, Arora, Samir, Buchanan, Patricia, Harris, Robert, Degarmo, Ronald, Guillen, Mario, Karns, Adam, Neutel, Joel, Paliwal, Yogesh, Pettis, Karlton, Toth, Phillip D., Wayne, Jeffrey M., Butcher, Bain, Diller, Phillip M., Oparil, Suzanne, Calhoun, David, Brautigam, Donald, Flack, John, Goldman, Jesse M., Rashidi, Arash, Aslam, Nabeel, Haley, William, Andrawis, Nabil, Lang, Brian, Miller, Randy, Powell, James, Dewhurst, Robert, Pritchard, James, Khanna, Dinesh, Tang, Dennis, Gabra, Nashwa, Park, Jean, Jones, Conigliaro, Scott, Cranford, Luna, Blanca, Mussaji, Murtaza, Bhagwat, Ravi, Bauer, Michael, McGinty, John, Nambiar, Rajesh, Sangrigoli, Renee, Ross Davis, William, Eaves, William, McGrew, Frank, Awad, Ahmed, Bolster, Eric, Scott, David, Kalirao, Paramjit, Dabel, Pascal, Calhoun, Wesley, Gouge, Steven, Warren, Mark, Lawrence, Mary Katherine, Jamal, Aamir, El-Shahawy, Mohamed, Mercado, Carlos, Kumar, Jayant, Velasquez-Mieyer, Pedro, Busch, Robert, Lewis, Todd, and Rich, Lisa

Abstract

Background: Resistant hypertension is associated with increased cardiovascular risk. The endothelin pathway has been implicated in the pathogenesis of hypertension, but it is currently not targeted therapeutically, thereby leaving this relevant pathophysiological pathway unopposed with currently available drugs. The aim of the study was to assess the blood pressure lowering efficacy of the dual endothelin antagonist aprocitentan in patients with resistant hypertension. Methods: PRECISION was a multicentre, blinded, randomised, parallel-group, phase 3 study, which was done in hospitals or research centres in Europe, North America, Asia, and Australia. Patients were eligible for randomisation if their sitting systolic blood pressure was 140 mm Hg or higher despite taking standardised background therapy consisting of three antihypertensive drugs, including a diuretic. The study consisted of three sequential parts: part 1 was the 4-week double-blind, randomised, and placebo-controlled part, in which patients received aprocitentan 12·5 mg, aprocitentan 25 mg, or placebo in a 1:1:1 ratio; part 2 was a 32-week single (patient)-blind part, in which all patients received aprocitentan 25 mg; and part 3 was a 12-week double-blind, randomised, and placebo-controlled withdrawal part, in which patients were re-randomised to aprocitentan 25 mg or placebo in a 1:1 ratio. The primary and key secondary endpoints were changes in unattended office systolic blood pressure from baseline to week 4 and from withdrawal baseline to week 40, respectively. Secondary endpoints included 24-h ambulatory blood pressure changes. The study is registered on ClinicalTrials.gov, NCT03541174. Findings: The PRECISION study was done from June 18, 2018, to April 25, 2022. 1965 individuals were screened and 730 were randomly assigned. Of these 730 patients, 704 (96%) completed part 1 of the study; of these, 613 (87%) completed part 2 and, of these, 577 (94%) completed part 3 of the study. The least square m

Published
2022

42. Angiotensin Receptor Blockers Evaluated by Office and Home Blood Pressure Measurements. TeleHBPM Study

Author

Barroso W, Brandao A, Vitorino P, Feitosa A, Barbosa E, Miranda R, Redon J, Camafort-Babkowski M, Coca A, and Gomes M

Abstract

BACKGROUND: Adequate treatment of arterial hypertension and achieving arterial hypertension goals in are important in reducing cardiovascular outcomes.; OBJECTIVES: To describe angiotensin receptor blockers in monotherapy or double combination therapy and the rate of arterial hypertension control.; METHODS: This cross-sectional study evaluated patients who were using angiotensin receptor blockers between 2017 and 2020. Those using three or more antihypertensive drugs were excluded. The analyzed variables included sex, age, body mass index, valid home blood pressure monitoring (HBPM) measurements, casual and HBPM systolic and diastolic blood pressure measurements, blood pressure variability, and antihypertensive and angiotensin receptor blocker class. Paired t, chi-square, and Fisher's exact tests were used, as well as overlapping 95% confidence intervals and a significance level of 5% (p < 0.05).; RESULTS: Of 17,013 patients, 12,813 met the inclusion criteria, 62.1% of whom were female. The mean number of valid measurements was 23.3 (SD, 2.0). The mean HBPM and casual measurements for systolic blood pressure were 126.8 (SD, 15.8) mmHg and 133.5 (SD, 20.1) mmHg (p

Published
2022

43. Healthy lifestyle, metabolomics and incident type 2 diabetes in a population-based cohort from Spain

Author

Delgado-Velandia M, Gonzalez-Marrachelli V, Domingo-Relloso A, Galvez-Fernandez M, Grau-Perez M, Olmedo P, Galan I, Rodriguez-Artalejo F, Amigo N, Briongos-Figuero L, Redon J, Martin-Escudero J, Monleon-Salvado D, Tellez-Plaza M, and Sotos-Prieto M

Subjects
Healthy lifestyle, Metabolomics, Type 2 diabetes, Cohort study, Spanish population
Abstract

Background: The contribution of metabolomic factors to the association of healthy lifestyle with type 2 diabetes risk is unknown. We assessed the association of a composite measure of lifestyle with plasma metabolite profiles and incident type 2 diabetes, and whether relevant metabolites can explain the prospective association between healthy lifestyle and incident type 2 diabetes. Methods: A Healthy Lifestyle Score (HLS) (5-point scale including diet, physical activity, smoking status, alcohol consumption and BMI) was estimated in 1016 Hortega Study participants, who had targeted plasma metabolomic determinations at baseline examination in 2001-2003, and were followed-up to 2015 to ascertain incident type 2 diabetes. Results: The HLS was cross-sectionally associated with 32 (out of 49) plasma metabolites (2.5% false discovery rate). In the subset of 830 participants without prevalent type 2 diabetes, the rate ratio (RR) and rate difference (RD) of incident type 2 diabetes (n cases= 51) per one-point increase in HLS was, respectively, 0.69 (95% CI, 0.51, 0.93), and - 8.23 (95% CI, - 16.34, - 0.13)/10,000 person-years. In single-metabolite models, most of the HLS-related metabolites were prospectively associated with incident type 2 diabetes. In probit Bayesian Kernel Machine Regression, these prospective associations were mostly driven by medium HDL particle concentration and phenylpropionate, followed by small LDL particle concentration, which jointly accounted for -50% of the HLS-related decrease in incident type 2 diabetes. Conclusions: The HLS showed a strong inverse association with incident type 2 diabetes, which was largely explained by plasma metabolites measured years before the clinical diagnosis.

Published
2022

44. Incidence and impact of atrial fibrillation in heart failure patients: real-world data in a large community

Author

Diaz J, Martinez F, Calderon J, Fernandez A, Sauri I, Uso R, Trillo J, Redon J, and Forner M

Subjects
Hospitalization, Stroke, Heart failure, All-cause mortality, Atrial fibrillation, Renal function
Abstract

Aims The objective of the present study is to assess the bidirectional association between heart failure (HF) and atrial fibrillation (AF) using real-world data. Methods and results From an electronic health recording with a population of 3 799 885 adult subjects, those with prevalent or incident HF were selected and followed throughout a study period of 5 years. Prevalence and incidence of AF, and their impact in the risk for acute HF hospitalization, worsening renal function, ischaemic and haemorrhagic stroke, and all-cause mortality were identified. We analysed all incident and prevalent patients with HF and AF, 128 086 patients (S1), and subsequently analysed a subset of patients with incident HF and AF, 57 354 patients (S2). We analysed all incident and prevalent patients with HF and AF, 128 086 patients (S1), and subsequently a subset of patients with incident HF and AF, 57 354 patients (S2). The prevalence of AF was 59 906 (46.7%) of the HF patients, while incidence in the 52 was 231/1000 patients/year. In both cohorts, S1 and S2, AF significantly increases the risk of acute heart failure hospitalization [incidence 79.1/1000 and 97.5/1000 patients/year; HR 1.53 (1.48-1.59 95% CI) and HR 1.32 (1.24-1.41 95% CI), respectively], risk of decreased renal function (eGFR reduced by >20%) [66.2/1000 and 94.0/1000 patients/year; HR 1.13 (1.09-1.18 95% CI) and HR 1.22 (1.14-1.31 95% CI), respectively] and all-cause mortality [203/1000 and 294/1000 patients/year; HR 1.62 (1.58-1.65 95% CI) and HR 1.65 (1.59-1.70 95% CI), respectively]. The number of episodes of hospitalization for acute heart failure was also significantly higher in the AF patients (27 623 vs. 10 036, P < 0.001). However, the risk for ischaemic stroke was reduced in the AF subjects [HR 0.66 (0.63-0.74 95% Cl)), probably due to the anticoagulant treatment. Conclusions AF is associated with an increment in the risk of episodes of acute heart failure as well as decline of renal function and increment of all-cause mortality.

Published
2022

45. Real-World Data of Anticoagulant Treatment in Non-valvular Atrial Fibrillation

Author

Calderon J, Martinez F, Diaz J, Fernandez A, Sauri I, Uso R, Trillo J, Vela S, Bea C, Redon J, and Forner M

Subjects
anticoagulant therapy, VKA, atrial fibrillation, NOACs, antiplatelet, stroke, mortality
Abstract

AimsTo assess the impact of anticoagulant treatment on risk for stroke and all-cause mortality of patients with atrial fibrillation using real-world data (RWD). MethodsPatients with prevalent or incident atrial fibrillation were selected throughout a study period of 5 years. Stroke, transitory ischemic attack, hemorrhagic stroke, and all-cause mortality were identified in the claims of the electronic health records (EHRs). Subjects were classified according to the anticoagulant treatment in four groups: untreated, vitamin K antagonists (VKAs), New Oral Anticoagulants (NOACs), and antiplatelet (AP). Risk of events and protection with anticoagulant therapy were calculated by Cox proportional hazard models adjusted by potential confounders. ResultsFrom a total population of 3,799,884 patients older than 18,123,227 patients with incident or prevalent atrial fibrillation (AF) were identified (mean age 75.2 +/- 11.5 years old; 51.9% women). In a follow-up average of 3.2 years, 17,113 patients suffered from an ischemic stroke and transitory ischemic attack (TIA), 780 hemorrhagic stroke, and 42,558 all-cause death (incidence of 46, 8, 2, and 120 per 1,000 patients/year, respectively). Among CHA2DS2, VASc Score equal or >2, 11.7% of patients did not receive any anticoagulant therapy, and a large proportion of patients, 47%, shifted from one treatment to another. Although all kinds of anticoagulant treatments were significantly protective against the events and mortality, NOAC treatment offered significantly better protection compared to the other groups. ConclusionIn the real world, the use of anticoagulant treatments is far from guidelines recommendations and is characterized by variability in their use. NOACs offered better protection compared with VKAs.

Published
2022

46. Gene-environment interaction analysis of redox-related metals and genetic variants with plasma metabolic patterns in a general population from Spain: The Hortega Study

Author

Galvez-Fernandez M, Sanchez-Saez F, Domingo-Relloso A, Rodriguez-Hernandez Z, Tarazona S, Gonzalez-Marrachelli V, Grau-Perez M, Morales-Tatay J, Amigo N, Garcia-Barrera T, Gomez-Ariza J, Chaves F, Garcia-Garcia A, Melero R, Tellez-Plaza M, Martin-Escudero J, Redon J, and Monleon D

Subjects
Metals, Oxidative stress, Metabolomics, Gene-environment interaction, Candidate genes
Abstract

Background: Limited studies have evaluated the joint influence of redox-related metals and genetic variation on metabolic pathways. We analyzed the association of 11 metals with metabolic patterns, and the interacting role of candidate genetic variants, in 1145 participants from the Hortega Study, a population-based sample from Spain. Methods: Urine antimony (Sb), arsenic, barium (Ba), cadmium (Cd), chromium (Cr), cobalt (Co), molybdenum (Mo) and vanadium (V), and plasma copper (Cu), selenium (Se) and zinc (Zn) were measured by ICP-MS and AAS, respectively. We summarized 54 plasma metabolites, measured with targeted NMR, by estimating metabolic principal components (mPC). Redox-related SNPs (N = 291) were measured by oligo-ligation assay. Results: In our study, the association with metabolic principal component (mPC) 1 (reflecting non-essential and essential amino acids, including branched chain, and bacterial co-metabolism versus fatty acids and VLDL subclasses) was positive for Se , Zn, but inverse for Cu, arsenobetaine-corrected arsenic (As) and Sb. The association with mPC2 (reflecting essential amino acids, including aromatic , bacterial co-metabolism) was inverse for Se, Zn and Cd. The association with mPC3 (reflecting LDL subclasses) was positive for Cu, Se and Zn, but inverse for Co. The association for mPC4 (reflecting HDL subclasses) was positive for Sb, but inverse for plasma Zn. These associations were mainly driven by Cu and Sb for mPC1; Se, Zn and Cd for mPC2; Co, Se and Zn for mPC3; and Zn for mPC4. The most SNP-metal interacting genes were NOX1, GSR, GCLC, AGT and REN. Co and Zn showed the highest number of interactions with genetic variants associated to enriched endocrine, car-diovascular and neurological pathways. Conclusions: Exposures to Co, Cu, Se, Zn, As, Cd and Sb were associated with several metabolic patterns involved in chronic disease. Carriers of redox-related variants may have differential susceptibility to metabolic alterations associated to excessive exposure to metals.

Published
2022

47. Exosomal and Plasma Non-Coding RNA Signature Associated with Urinary Albumin Excretion in Hypertension

Author

Riffo-Campos A, Perez-Hernandez J, Ortega A, Martinez-Arroyo O, Flores-Chova A, Redon J, and Cortes R

Subjects
hypertension, non-coding RNA, urinary albumin excretion, exosomes, plasma
Abstract

Non-coding RNA (ncRNA), released into circulation or packaged into exosomes, plays important roles in many biological processes in the kidney. The purpose of the present study is to identify a common ncRNA signature associated with early renal damage and its related molecular pathways. Three individual libraries (plasma and urinary exosomes, and total plasma) were prepared from each hypertensive patient (with or without albuminuria) for ncRNA sequencing analysis. Next, an RNA-based transcriptional regulatory network was constructed. The three RNA biotypes with the greatest number of differentially expressed transcripts were long-ncRNA (lncRNA), microRNA (miRNA) and piwi-interacting RNA (piRNAs). We identified a common 24 ncRNA molecular signature related to hypertension-associated urinary albumin excretion, of which lncRNAs were the most representative. In addition, the transcriptional regulatory network showed five lncRNAs (LINC02614, BAALC-AS1, FAM230B, LOC100505824 and LINC01484) and the miR-301a-3p to play a significant role in network organization and targeting critical pathways regulating filtration barrier integrity and tubule reabsorption. Our study found an ncRNA profile associated with albuminuria, independent of biofluid origin (urine or plasma, circulating or in exosomes) that identifies a handful of potential targets, which may be utilized to study mechanisms of albuminuria and cardiovascular damage.

Published
2022

48. Real world data of anticoagulant treatment in non-valvular atrial fibrillation across renal function status

Author

Calderon J, Martinez F, Fernandez A, Sauri I, Diaz J, Uso R, Trillo J, Redon J, and Forner M

Abstract

The objective is to assess the impact of anticoagulant treatment in non-valvular atrial fibrillation (AF) and different categories of renal dysfunction in real world. Electronic Health recordings of patients with diagnosis of AF and renal function collected throughout 5years and classified according to KDIGO categories. Stroke, transitory ischemic attack (TIA), intracranial hemorrhage and all-cause mortality were identified. Anticoagulant treatments during the study period were classified in untreated (never received therapy), VKA, NOAC and Aspirin. The risk of events was calculated by Cox-proportional hazard models adjusted by confounders. A total of 65,734 patients with AF, mean age 73.3±10.49years old and 47% females and follow-up of 3.2years were included. KDIGO classification were: G1 33,903 (51.6%), G2 17,456 (26.6%), G3 8024 (12.2%) and G4 6351 (9.7%). There were 8592 cases of stroke and TIA, 437 intracranial hemorrhage, and 9603 all-cause deaths (incidence 36, 2 and 38 per 103 person/year, respectively). 4.1% of patients with CHA2DS2-VASc Score 2 or higher did not receive anticoagulant therapy. Risk of stroke, TIA, and all-cause mortality increased from G1 to G4 groups. Anticoagulant treatments reduced the risk of events in the four categories, but NOAC seemed to offer significantly better protection. Renal dysfunction increases the risk of events in AF and anticoagulant treatments reduced the risk of stroke and all-cause mortality, although NOAC were better than VKA. Efforts should be done to reduce the variability in the use of anticoagulants even in this high risk group. © 2022. The Author(s).

Published
2022

49. Insights From Matched Office and Ambulatory Blood Pressure in Youth: Clinical Relevance

Author

Lurbe E, Redon J, Alvarez J, Grau-Perez M, Martinez F, and Mancia G

Abstract

BACKGROUND: Information on the relationship between ambulatory blood pressure (ABP) and concurrently office blood pressure (BP) values in youth still suffers from limitations. We provide information on the differences between office BP and ABP, the factors related, and the clinical implications.; METHODS: Three thousand six hundred ninety matched measurements of office BP and ABP on the same day, from 2390 children, aged 5 to 15 years, of both sexes were eligible. Office BP was measured using an oscillometric device (Omron 705 IT) and 24-hour ABP using oscillometric SpaceLabs 90207. Average of office, 24-hour, daytime, nighttime, systolic, and diastolic BP and heart rate was calculated. BP categories according to the European guidelines and phenotype of mismatch office BP versus ABP were defined.; RESULTS: Both daytime systolic and diastolic BP were higher than office BP with a progressive reduction of the differences from 5 to 15 years. The office minus daytime BP differences were the largest in normotensive subjects, less at high-normal, and reversed in hypertensive ones, independently of age and weight status. White coat and masked hypertension covered no more than 13.6% at all ages.; CONCLUSIONS: In youth, it is inaccurate to obtain reference values for ABP by extrapolating from office BP values. The differences between office BP and ABP are minimal in children with office BP values in the range of hypertension, reinforcing the recommendation to use ABP measurement at the time to confirm hypertension.

Published
2022

50. Biofluid Specificity of Long Non-Coding RNA Profile in Hypertension: Relevance of Exosomal Fraction

Author

Riffo-Campos A, Perez-Hernandez J, Martinez-Arroyo O, Ortega A, Flores-Chova A, Redon J, and Cortes R

Abstract

Non-coding RNA (ncRNA)-mediated targeting of various genes regulates the molecular mechanisms of the pathogenesis of hypertension (HTN). However, very few circulating long ncRNAs (lncRNAs) have been reported to be altered in essential HTN. The aim of our study was to identify a lncRNA profile in plasma and plasma exosomes associated with urinary albumin excretion in HTN by next-generation sequencing and to assess biological functions enriched in response to albuminuria using GO and KEGG analysis. Plasma exosomes showed higher diversity and fold change of lncRNAs than plasma, and low transcript overlapping was found between the two biofluids. Enrichment analysis identified different biological pathways regulated in plasma or exosome fraction, which were implicated in fatty acid metabolism, extracellular matrix, and mechanisms of sorting ncRNAs into exosomes, while plasma pathways were implicated in genome reorganization, interference with RNA polymerase, and as scaffolds for assembling transcriptional regulators. Our study found a biofluid specific lncRNA profile associated with albuminuria, with higher diversity in exosomal fraction, which identifies several potential targets that may be utilized to study mechanisms of albuminuria and cardiovascular damage.

Published
2022

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