Search Results (5)

China produces the largest amount of CO₂ emissions since 2007 and is the second largest economy in the world since 2010, and the Yangtze River Delta (YRD) area plays a crucial role in promoting low-carbon development in China. Analyzing its evolutionary characteristics of spatial and temporal patterns and its decoupling effect is of great importance for the purpose of low-carbon development. However, this analysis relies on the estimation of CO₂ emissions. Recently, neural network-based models are widely used for CO₂ emission estimation. To improve the performance of neural network models, the Aquila Optimizer (AO) algorithm is introduced to optimize the hyper-parameter values in the back-propagation (BP) neural network model in this research due to the appealing searching capability of AO over traditional algorithms. Such a model is referred to as the AO-BP model, and this paper uses the AO-BP model to estimate carbon emissions, compiles a city-level CO₂ emission inventory for the YRD region, and analyzes the spatial dependence, spatial correlation characteristics, and decoupling status of carbon emissions. The results show that the CO₂ emissions in the YRD region show a spatial distribution pattern of “low in the west, high in the east, and developing towards the west”. There exists a spatial dependence of carbon emissions in the cities from 2001 to 2022, except for the year 2000, and the local spatial autocorrelation test shows that high-high is concentrated in Shanghai and Suzhou, and low-low is mainly centered in Anqing, Chizhou, and Huangshan in southern Anhui. Furthermore, there exist significant regional differences in the correlation levels of CO₂ emissions between cities, with a trend of low in the west and high in the east in location, and a decreasing and then increasing trend in time. From 2000 to 2022, the decoupling of carbon emissions and economic growth shows a steadily improving trend. Full article

Background: The aim of this study was to evaluate the prognostic value of automated office blood pressure (AOBP) measurement in patients with hypertension and chronic kidney disease (CKD) stage 3–5 not on dialysis. Methods: At baseline, 140 patients were recruited, and blood pressure (BP) measurements with 3 different methods, namely, office blood pressure (OBP), AOBP, and ambulatory blood pressure measurement (ABPM), were recorded. All patients were prospectively followed for a median period of 3.4 years. The primary outcome of this study was a composite outcome of cardiovascular (CV) events (both fatal and nonfatal) or a doubling of serum creatine or progression to end-stage kidney disease (ESKD), whichever occurred first. Results: At baseline, the median age of patients was 65.2 years; 36.4% had diabetes; 21.4% had a history of CV disease; the mean of estimated glomerular filtration rate (eGFR) was 33 mL/min/1.73 m²; and the means of OBP, AOBP, and daytime ABPM were 151/84 mm Hg, 134/77 mm Hg, and 132/77 mm Hg, respectively. During the follow-up, 18 patients had a CV event, and 37 patients had a renal event. In the univariate cox regression analysis, systolic AOBP was found to be predictive of the primary outcome (HR per 1 mm Hg increase in BP, 1.019, 95% CI 1.003–1.035), and after adjustment for eGFR, smoking status, diabetes, and a history of CV disease and systolic and diastolic AOBP were also found to be predictive of the primary outcome (HR per 1 mm Hg increase in BP, 1.017, 95% CI 1.002–1.032 and 1.033, 95% CI 1.009–1.058, respectively). Conclusions: In patients with CKD, AOBP appears to be prognostic of CV risk or risk for kidney disease progression and could, therefore, be considered a reliable means for recording BP in the office setting. Full article

Though the relationship between both “attended” and “unattended” BP and several forms of target organ damage have been evaluated, data on retinal arteriolar alterations are lacking. The aim of our study was to evaluate the relationship between “attended” or “unattended” BP values and retinal arteriolar changes in consecutive individuals undergoing a clinical evaluation and assessment of retinal fundus at an ESH Excellence Centre. An oscillometric device programmed to perform 3 BP measurements, at 1 min intervals and after 5 min of rest was used on all individuals to measure BP with the patient alone in the room (“unattended”) or in the presence of the physician (“attended”) in the same day in a random order. The retinal arteriole’s wall thickness (WT) was measured automatically by a localization algorithm as the difference between external (ED) and internal diameter (ID) by adaptive optics (RTX-1, Imagine Eyes, Orsay, Francia). Media-to-lumen ratio (WLR) of the retinal arterioles and cross-sectional area (WCSA) of the vascular wall were calculated. Results: One-hundred-forty-two patients were examined (mean age 57 ± 12 yrs, 48% female, mean BMI 26 ± 4). Among them, 60% had hypertension (84% treated) and 11% had type 2 diabetes mellitus. Unattended systolic BP (SBP) was lower as compared to attended SBP (129 ± 14.8. vs. 122.1 ± 13.6 mmHg, p < 0.0001). WLR was similarly correlated with unattended and attended SBP (r = 0.281, p < 0.0001 and r = 0.382, p < 0.0001) and with unattended and attended diastolic BP (r = 0.34, p < 0.001 and r = 0.29, p < 0.0001). The differences between correlations were not statistically significant (Steiger’s Z test). Conclusion: The measurement of “unattended” or “attended” BP provides different values, and unattended BP is lower as compared to attended BP. In this study a similar correlation was observed between attended and unattended BP values and structural changes of retinal arterioles. Full article

(1) Background: It is essential to increase the awareness of cardiovascular diseases’ symptoms and reduce treatment delays among women with hypertension (HTN). This study aimed to assess the knowledge of cardio-cerebrovascular diseases’ warning signs (KCVDs), according to awareness of their blood pressure levels (AoBP), and identify the factors associated with KCVDs and AoBP in women with HTN. (2) Methods: This study used the data from the Korea Community Health Survey of 2018. A total of 29,832 women with HTN were included in the final analysis. Data on sociodemographic characteristics, KCVDs, and AoBP were identified. A negative binomial regression was used to identify factors associated with KCVDs. (3) Results: Of the participants, 42.9% were not aware of their blood pressure level, and 9.1% did not have any knowledge of KCVD symptoms. Factors associated with KCVDs were AoBP (odds ratio (OR) = 1.121, p < 0.001), middle age (OR = 1.012, p = 0.008), employment (OR = 1.034, p < 0.017), and being married and living with a spouse (OR = 1.068, p < 0.001). Lower levels of education (OR = 0.931, p < 0.001) and regular walking (OR = 0.964, p = 0.015) were also associated with KCVDs. Health-related quality of life (HRQoL) and subjective health status were associated with increased AoBP. (4) Conclusions: AoBP was positively associated with KCVDs. It is necessary to include AoBP in public campaigns and regular policy support to improve KCVDs. In addition, findings in this study can serve as basic data for developing socio-cultural interventions, aimed at mitigating cardio-cerebrovascular diseases, by improving levels of KCVDs. Full article

Introduction: Obstructive sleep apnoea (OSA) is a well-known risk factor for masked hypertension (MH) and masked uncontrolled hypertension (MUCH). Automated ambulatory office blood pressure measurement (AOBP) might better correlate with the results of ambulatory blood pressure measurements (ABPM) compared to routine office blood pressure measurement (OBPM). The aim of this study was to compare the diagnostic rate of MH/MUCH when using OBPM and AOBP in combination with ABPM. Material and methods: 65 OSA patients, of which 58 were males, (AHI > 5, mean 44.4; range 5–103) of average age 48.8 ± 10.7 years were involved in this study. Following MH/MUCH criteria were used; Criteria I: OBPM < 140/90 mm Hg and daytime ABPM > 135/85 mm Hg; Criteria II: AOBP < 140/90 mm Hg and daytime ABPM > 135/85 mm Hg; Criteria III: AOBP < 135/85 mm Hg and daytime ABPM > 135/85 mm Hg. Results: MH/MUCH criteria I was met in 16 patients (24.6%) with criteria II being met in 37 patients (56.9%), and criteria III in 33 (51.0%), p < 0.0001. Both systolic and diastolic OBPM were significantly higher than AOBP; Systolic (mm Hg): 135.3 ± 12.3 vs. 122.1 ± 10.1 (p < 0.0001); Diastolic (mm Hg): 87.4 ± 8.9 vs. 77.1 ± 9.3 (p < 0.0001). AOBP was significantly lower than daytime ABPM; Systolic (mm Hg): 122.1 ± 10.1 vs. 138.9 ± 10.5 (p < 0.0001); Diastolic (mm Hg): 77.1 ± 9.3 vs. 81.6 ± 8.1 (p < 0.0001). Non-dipping phenomenon was present in 38 patients (58.4%). Nocturnal hypertension was present in 55 patients (84.6%). Conclusions: In patients with OSA there is a much higher prevalence of MH/MUCH despite normal AOBP, therefore it is necessary to perform a 24-hour ABPM even if OBPM and AOBP are normal. Full article