In silico prediction of optimal multifactorial intervention in chronic kidney disease.

Background: Chronic kidney disease (CKD) contributes to global morbidity and mortality. Early, targeted intervention can help mitigate its impact. CK273 is a urinary peptide classifier previously validated in a prospective clinical trial for the early detection of nephropathy.

Ventricular-arterial coupling is preserved in prematurely born 11-year-old children but calls for life-long prevention of hemodynamic deterioration.

Background: Premature birth disrupts the intra-uterine structural and functional maturation of the left ventricle (LV) and arteries. The study investigated the impact of premature birth on ventricular-arterial coupling (VAC), a potential precursor of cardiovascular disease in adulthood.

Methods: This case-control study in Northern Belgium (2011-2016) included 93 extremely-low-birth-weight (ELBW) cases and 87 sex and age-matched term-born controls.

Cardiovascular Outcomes and Variability in Plasma Lipid Levels Across Body Mass Index Categories: The ARIC Study.

The aim of this study was to investigate associations of cardiovascular outcomes with lipid variability across body mass index categories. We identified 6689 participants (57.1% women) enrolled in the Atherosclerosis Risk In Communities (ARICs) study who had ≥ 3 measurements of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C).

Evaluation of race-free eGFR equations in individuals of different ethnicity.

Background: Glomerular filtration rate (eGFR) derived from serum creatinine (eGFR), cystatin C (eGFR), or both (eGFR) by race-free equations are recommended staging chronic kidney disease (CKD). The current study aimed to compare these race-free eGFR equations for screening for low-grade CKD in Blacks and non-Blacks and to evaluate their association with mortality.

Methods: Race-free eGFR equations were evaluated in four studies with specific inclusion criteria based on the original research goals: African-PREDICT (341/380 healthy Black/White South Africans), FLEMENGHO (709 White community-dwelling Flemish), NHANES (1760/7931 Black and non-Black adult Americans), and 401 Black African patients hospitalised in Mbuji Mayi, Democratic Republic of Congo.

Myocardial Blood Flow and the Retinal Microvasculature Across the Spectrum From Normal to Failing Hearts.

Deficiency of the myocardial microcirculation plays a role in the pathogenesis of heart failure (HF). We aimed to investigate the association of myocardial blood flow (MBF) and the retinal microvasculature with left ventricular (LV) function and its potential mediators. In healthy controls (HCs; n = 48), patients with cardiovascular risk factors (CVRF; n = 49) and patients with compensated HF (CHF; n = 52), we assessed LV diastolic filling pressure (E/e'), LV ejection fraction (LVEF), and global longitudinal strain (GLS) associated with MBF and the retinal arteriole-to-venule ratio (AVR), using multivariable regression models, while considering their direct contributions to LV function and the indirect contributions running via NT-proBNP.

Stenotic Lesions of the Intracranial Arteries in Relation to the Average Level and Variability of the Home Blood Pressure: A Cross-Sectional Study.

Background: This study assessed the presence of intracranial arterial stenosis (ICAS) in relation to home systolic blood pressure (SBP) and its variability (BPV).

Methods: In 1510 untreated patients, ICAS was assessed by transcranial Doppler ultrasonography. SBP and BPV were determined from individual home BP recordings over seven days with triplicate readings in the morning and evening.

Ambulatory blood pressure monitoring, European guideline targets, and cardiovascular outcomes: an individual patient data meta-analysis.

Background And Aims: Hypertension is the predominant modifiable cardiovascular risk factor. This cohort study assessed the association of risk with the percentage of time that the ambulatory blood pressure (ABP) is within the target range (PTTR) proposed by the 2024 European Society of Cardiology (ESC) guidelines for blood pressure (BP) management.

Methods: In a person-level meta-analysis of 14 230 individuals enrolled in 14 population cohorts, systolic and diastolic ABPs were combined to assess 24-h, daytime, and nighttime PTTR with thresholds for non-elevated ABP set at <115/65, <120/70, and <110/60 mmHg, respectively.

Effects of intensive blood pressure treatment on orthostatic hypertension: individual level meta-analysis.

Objective: To determine the effects of intensive blood pressure treatment on orthostatic hypertension.

Design: Systematic review and individual participant data meta-analysis.

Data Sources: MEDLINE, Embase, and Cochrane CENTRAL databases through 13 November 2023.

A randomised trial comparing usual versus strict home blood pressure control in elderly patients with hypertension: protocol and initial progress.

. The optimal level of home blood pressure (HBP) for the prevention of cardiovascular complications is unknown. The Home Blood Pressure Intervention in the Community Trial (HomeBP, [NCT05858944]) is addressing this issue by randomising elderly hypertensive patients to standard or tight HBP control.

Health risks related to environmental and occupational lead exposure.

Lead is a ubiquitous toxic metal. This review summarizes the toxicokinetics and toxicology of lead, and the methods to measure blood lead (BL), summarizes recently published studies, and ends with an appraisal of recent regulations to protect exposed workers. Lead exposure is caused via inhalation of lead-contaminated particulate and via gastrointestinal uptake.

Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave.

Prognostic significance of the timing in the cardiac cycle of the first (TP1) and second (TP2) systolic peak of the central aortic pulse wave is ill-defined. Incidence rates and standardized multivariable-adjusted hazard ratios (HRs) of adverse health outcomes associated with TP1 and TP2, estimated by the SphygmoCor software, were assessed in the International Database of Central Arterial Properties for Risk Stratification (IDCARS) (n = 5529). Model refinement was assessed by the integrated discrimination (ID) and net reclassification (NR) improvement.

Racial and regional disparities in the risk of noncommunicable disease between sub-Saharan black and European white patients.

Objectives: Greater vulnerability of Black vs. White individuals to cardiovascular disease (CVD) and chronic kidney disease (CKD) is well charted in the United States, but studies involving sub-Saharan blacks are scarce.

Methods: Baseline data (2021-2024) were collected in 168 sub-Saharan Blacks and 93 European Whites in an ongoing clinical trial (NCT04299529), using standardized patient selection criteria.

Urinary Proteomics and Systems Biology Link Eight Proteins to the Higher Risk of Hypertension and Related Complications in Blacks Versus Whites.

Blacks are more prone to salt-sensitive hypertension than Whites. This cross-sectional analysis of a multi-ethnic cohort aimed to search for proteins potentially involved in the susceptibility to salt sensitivity, hypertension, and hypertension-related complications. The study included individuals enrolled in African Prospective Study on the Early Detection and Identification of Cardiovascular Disease and Hypertension (African-PREDICT), Flemish Study of the Environment, Genes and Health Outcomes (FLEMENGHO), Prospective Cohort Study in Patients with Type 2 Diabetes Mellitus for Validation of Biomarkers (PROVALID)-Austria, and Urinary Proteomics Combined with Home Blood Pressure Telemonitoring for Health Care Reform Trial (UPRIGHT-HTM).

Perinatal risk factors of renal outcome in former extremely low birth weight neonates.

Unlabelled: Former Extremely Low Birthweight (ELBW) neonates suffer from adverse renal and cardiovascular outcomes later in life. Less is known about additional perinatal risk factors for these adverse outcomes which we have investigated in this study. We compared renal outcome between ELBW children and controls, to find perinatal risk factors for poorer renal outcome and to unveil associations between kidney function and blood pressure.

Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure.

Aims: Few randomized trials assessed the changes over time in the chronotropic heart rate (HR) reactivity (CHR), HR recovery (HRR) and exercise endurance (EE) in response to the incremental shuttle walk test (ISWT). We addressed this issue by analysing the open HOMAGE (Heart OMics in Aging) trial.

Methods: In HOMAGE, 527 patients prone to heart failure were randomized to usual treatment with or without spironolactone (25-50 mg/day).

Osteoporosis in Relation to a Bone-Related Aging Biomarker Derived from the Urinary Proteomic Profile: A Population Study.

Screening for and prevention of osteoporosis and osteoporotic fractures is imperative, given the high burden on individuals and society. This study constructed and validated an aging-related biomarker derived from the urinary proteomic profile (UPP) indicative of osteoporosis (UPPost-age). In a prospective population study done in northern Belgium (1985-2019), participants were invited for a follow-up examination in 2005-2010 and participants in the 2005-2010 examination again invited in 2009-2013.

Efficacy of antihypertensive treatment for target organ protection in patients with masked hypertension (ANTI-MASK): a multicentre, double-blind, placebo-controlled trial.

Background: Masked hypertension is associated with target organ damage (TOD) and adverse health outcomes, but whether antihypertensive treatment improves TOD in patients with masked hypertension is unproven.

Methods: In this multicentre, randomised, double-blind, placebo-controlled trial at 15 Chinese hospitals, untreated outpatients aged 30-70 years with an office blood pressure (BP) of <140/<90 mm Hg and 24-h, daytime or nighttime ambulatory BP of ≥130/≥80, ≥135/≥85, or ≥120/≥70 mm Hg were enrolled. Patients had ≥1 sign of TOD: electrocardiographic left ventricular hypertrophy (LVH), brachial-ankle pulse wave velocity (baPWV) ≥1400 cm/s, or urinary albumin-to-creatinine ratio (ACR) ≥3.

An outcome-driven threshold for pulse pressure amplification.

Pulse pressure amplification (PPA) is the brachial-to-aortic pulse pressure ratio and decreases with age and cardiovascular risk factors. This individual-participant meta-analysis of population studies aimed to define an outcome-driven threshold for PPA. Incidence rates and standardized multivariable-adjusted hazard ratios (HRs) of cardiovascular and coronary endpoints associated with PPA, as assessed by the SphygmoCor software, were evaluated in the International Database of Central Arterial Properties for Risk Stratification (n = 5608).

Urinary proteomic signature of mineralocorticoid receptor antagonism by spironolactone: evidence from the HOMAGE trial.

Objective: Heart failure (HF) is characterised by collagen deposition. Urinary proteomic profiling (UPP) followed by peptide sequencing identifies parental proteins, for over 70% derived from collagens. This study aimed to refine understanding of the antifibrotic action of spironolactone.