Search Results (2,960)

Background: Load carriage is an activity of daily living, can be an occupational risk, and is a popular method of resistance training. Type of carry could be related to vascular and blood pressure (BP) responses and may be related to cardiovascular risk. As physical activity is recommended by clinicians and exercise physiologists, understanding the vascular responses in relation to type of carry is important to consider in terms of risk. The purpose of this study was to compare the vascular health and BP responses to the farmer’s handle (load at the side of the body) and zercher (load in front of the body) carry and to examine sex differences in the responses. Methods: A total of 38 adults (22 females and 16 males) completed farmer’s handle and zercher load carriage with pre- and post-vascular measurements using pulse wave analysis. Results: We found that load carriage with weight in front of the body (zercher) elicits a larger increase in arterial stiffness (AIx@75), and load carriage with the load on the side of the body (farmer’s handle) elicits a larger increase in peripheral systolic BP. There were no sex differences in the responses to carry. Females exercise (3.1 vs. 4.8) and weight train (1.5 vs. 2.6) fewer times per week and had a lower resting systolic BP (121.5 ± 10.3 vs. 131.3 ± 8.3 mmHg) (p < 0.05). Both types of load carriage increased peripheral systolic BP, central systolic BP, and vascular stiffness (p < 0.05). Conclusions: Location of load carriage is important to consider based on potential cardiac risk of patients. Full article

Background/Objectives: Individuals with posttraumatic stress disorder (PTSD) tend to show patterns of elevated cardiovascular disease (CVD) risk earlier in life than the general population. The need for effective interventions for CVD risk-reduction in PTSD is increasingly evident. In this paper we present preliminary results from a longitudinal study of a health behavior intervention, as an adjunct to standard trauma therapy in PTSD. The health behavior intervention addresses CVD-related heath behaviors (physical activity, nutrition, sleep, and stress) in a 12-week program delivered individually in 90-min sessions. Behavior change recommendations included: increased aerobic activity; establishing a balanced diet, enhancing consumption of fruits and vegetables and reducing sugars and fat/saturated fat; incorporating strategies to enhance sleep and lower PTSD-related disruptions (e.g., nightmares); and relaxation and cognitive coping skills to reduce general stress. Methods: Participants were randomized to the health behavior intervention plus standard trauma therapy experimental condition or a standard trauma therapy control group. Outcomes were measured at baseline and after the 12-week intervention phase. Sleep efficiency was measured from actigraphy watches. Physical activity was assessed by self-report and blood pressure was measured using an automated device. The preliminary outcomes are for 29 participants to date who have pre-post data. Results: Sleep efficiency was improved in the intervention group compared to controls (p < 0.05). The intervention group also evidenced significant pre-post increases in moderate physical activity compared to the control group (p < 0.05). Changes in vigorous physical activity did not reach statistical significance in this preliminary sample but the pattern of results are similar to those for moderate activity. Trends toward significance were also observed for pre-post changes in systolic (p = 0.06) and diastolic blood pressure (p = 0.07), with small reductions for the intervention group and increases for the control group. Conclusions: These findings provide preliminary information about the effectiveness of the health behavior intervention on multiple parameters for adults with PTSD. The findings suggest that focusing on health behavior change in multidisciplinary treatments for PTSD may enhance outcomes such as sleep and physical activity and potentially result in greater quality of life. However, the small preliminary sample size reported here should be considered when interpreting the outcomes. Further research may also determine how improvements in health parameters impact other indices of long-term cardiovascular health. Full article

Background: Dietary sodium restriction in people with chronic kidney disease (CKD) may improve blood pressure and cardiovascular outcomes. However, little is known about body sodium levels (and dietary sodium restriction) on patient-reported health-related quality of life (HRQOL) in CKD. The primary aim of this study was to assess potential relationships between routinely used sodium measurements in clinical practice and acceptance of diet and fluid restrictions with HRQOL outcomes in people with CKD. Methods: We conducted a cross-sectional pilot study in 53 people with CKD, including those on dialysis, to explore relationships between HRQOL outcomes using the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire and measures of dietary sodium intake and urinary sodium excretion. Results: Participants with low 24 h urinary sodium excretion reported poorer HRQOL in kidney-specific domains with lower KDQOL-36 component scores for effects of kidney disease (p = 0.03) and a trend towards lower scores in burden of kidney disease and symptoms of kidney disease (both p = 0.06). Those who had lower acceptance of fluid and diet restriction had poorer HRQOL in kidney-specific domains with lower KDQOL-36 component scores for burden of kidney disease and effects of kidney disease (all p ≤ 0.01). Conclusions: Low 24 h urinary sodium excretion and lower acceptance of fluid and diet restriction in people with CKD are associated with poorer HRQOL scores in domains that assess level of kidney disease interference with life. Further studies exploring underlying mechanisms between urinary sodium excretion and HRQOL in CKD are needed. Efforts to increase acceptance of diet and fluid restrictions in people with CKD may improve HRQOL outcomes. Full article

Background: For patients on hemodialysis, routine blood pressure (BP) measurements taken shortly before or after dialysis provide inaccurate estimates of the BP load during the interdialytic period. In this study, we used peridialytic recordings in combination with interdialytic ambulatory BP monitoring (ABPM) aiming to provide a more precise assessment of hypertension in a sample of 70 stable hemodialysis patients. Methods: The evaluation of hypertension in the study cohort was performed using the following approaches: (i) routine predialysis and postdialysis BP measurements taken by the dialysis-unit staff were prospectively recorded over six consecutive dialysis sessions; (ii) ABPM was performed using the Microlife WatchBPO3 device (20 min intervals during an entire 44 h interdialytic period). The diagnostic thresholds of hypertension were ≥140/90 mmHg for predialysis, ≥130/80 mmHg for postdialysis and ≥130/80 mmHg for 44 h ambulatory BP, respectively. Patients receiving ≥1 antihypertensive medication also were classified as hypertensives. Results: The prevalence of hypertension was 88.6% by predialysis, 92.9% by postdialysis and 90.0% by ambulatory BP measurements. In all, 87.1% of patients were being treated for hypertension. When the combination of predialysis and 44 h ambulatory BP was evaluated, the prevalence of sustained normotension, white-coat, masked and sustained hypertension was 52.9%, 21.4%, 5.7% and 20.0%, respectively. A similar distribution of patients into these phenotypes was observed when postdialysis BP was used for the classification of the severity of hypertension (50.0%, 24.3%, 5.7% and 20.0% for sustained normotension, white-coat, masked and sustained hypertension, respectively). Interdialytic ABPM revealed that just one patient had abnormal BP solely during the daytime period. Conversely, isolated nocturnal hypertension was diagnosed in 27.1% of patients. Conclusions: This study shows that among patients on hemodialysis, peridialytic BP is an inaccurate proxy of interdialytic ambulatory BP. In approximately 30% of patients, there is discordance between routine peridialytic recordings and interdialytic ABPM for the diagnosis of hypertension. ABPM also facilitates the diagnosis of isolated nocturnal hypertension, which is another frequent BP phenotype in this high-risk patient population. Full article

Background: Maintaining thermal homeostasis is a basic function of the human body. This homeostasis depends largely on the body’s nutritional status and other conditions related to it. Aim: The present study investigated the impact of 8 days of water-only fasting (8DW-F) on selected features of thermal homeostasis, taking into account somatic, metabolic, and circulatory changes in middle-aged men. Methods: A total of 13 healthy men took part in the experiment. Volunteers were examined twice: after a mixed diet (C) and after using 8DW-F. At baseline, the following were recorded: body mass (BM), body fat (FM), fat-free mass (FFM), and total water (TBW), along with basal metabolic rate (BMR) and body surface area (BSA). Then, after 30 min of sitting under thermoneutral conditions, the following measurements were taken: eardrum temperature (Ti), skin temperatures (Tsk), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen uptake (VO₂), and respiratory exchange ratio (RER). The following were then calculated: average body (MTB) and skin temperature (MTsk), resting metabolic rate (RMR), body to skin temperature gradient (g), and whole-body thermal conductivity (C). Results: The results showed that 8DW-F cause a significant reduction in most somatic variables as well as SBP and BMR (p < 0.001), RMR (p < 0.05) with no changes in Ti, MTsk, MTB, or C and g (p = 0.09). There were also significant correlations between Δ MTB × Δ BMR (p < 0.05) and Δ RMR × Δ VO₂ (p < 0.001). Moreover, changes in the C range correlated with Δ RMR (p < 0.005) and Δ DBP (p < 0.05). Conclusions: 8DW-F reduced resting metabolic heat production in the studied men, but sufficient heat conservation ensured that thermal homeostasis was maintained under thermally neutral conditions. Full article

Background/Objectives: Increased blood pressure variability (BPV) was found in adults with primary (essential) hypertension (PH) and is associated with increased cardiovascular risk. Our study aimed to analyze the relation between BPV and low-grade inflammation in children with primary hypertension. Methods: In 56 treatment-naive pediatric patients with PH (15.1 ± 2.1 years) and 30 healthy children (14.9 ± 1.4 years), we evaluated BPV: BP dipping, standard deviation (SD) of ambulatory blood pressure measurements (ABPMs), pulse pressure (PP)/systolic blood pressure ratio (24 h PP/SBP), rate–pressure index (24 h RPI), 24-h weighted BPV (24 h WSBPV, 24 h WDBV, 24 h WMAPV), coefficient of variation (24 h CoVSBP, 24 h CoVDBP, 24 h CoVMAP), ambulatory arterial stiffness index (AASI), and morning BP surge. We also analyzed indices of subclinical inflammation (markers derived from complete blood count, high-sensitivity C-reactive protein (CRP), interleukin 18), and office and ambulatory BP. Results: Patients with PH had significantly higher hsCRP, neutrophils, monocytes, and platelets, neutrophil-to-lymphocyte (NLR), platelet-to-mean platelet volume (PMPVR), and lower monocyte-to-neutrophil (MNR) ratios, and higher BPV: 24 h ABPM SBP SD, 24 h ABPM MAP SD, 24 h RPI, 24 h WSBPV, 24 h WDBV, 24 h WMAPV, and 24 h CoVSBP. Low-grade inflammation markers correlated with BPV indices in both groups. In multivariate analysis, MNR predicted 24 h ABPM MAP SD (beta = 0.290, 95CI: 0.029–0.551), 24 h RPI (beta = −0.348, 95CI: −0.587–−0.108), and 24 h WDBPV (beta = 0.286, 95CI: 0.032–0.540); monocyte count—24 h RPI (beta = 0.281, 95CI: 0.041–0.521), and hsCRP—24 h WDBV (beta = 0.310, 95CI: 0.055–0.564). ROC analysis revealed a good diagnostic profile for lymphocyte count as a positive determinant of non-dipping status in PH children (cut-off point 2.59 [×10³/µL]). Conclusions: BPV is higher in children with PH compared to healthy peers and is associated with low-grade inflammation. MNR may be the most helpful indicator of BPV, whereas high lymphocyte count predicts the best non-dipping status in these patients. Full article

Background and Objectives: Feces-induced peritonitis (FIP), a clinically relevant model of polymicrobial sepsis, induces systemic inflammation and acute lung injury (ALI). Methylene blue (MB), a phenothiazine-based compound, exhibits vasoregulatory, antioxidant, and anti-inflammatory properties in the context of sepsis. This study aimed to evaluate the protective effects of MB on pulmonary injury in a rat model of FIP-induced sepsis. Materials and Methods: Forty male Wistar rats were randomly assigned to four groups: control, FIP, FIP + Saline, and FIP + MB. MB was administered intraperitoneally at a dose of 20 mg/kg, 1 h after FIP induction. At 24 h post-induction, plasma levels of inflammatory markers [interleukin-6 (IL-6), interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP)], oxidative stress marker [malondialdehyde (MDA)], metabolic indicator [lactic acid], and vascular signaling marker [cyclic guanosine monophosphate (cGMP)] were measured. Lung injury was evaluated through histopathological analysis and thoracic computed tomography (CT)-based Hounsfield unit (HU) quantification, while pulmonary function was assessed via arterial blood gas analysis, including arterial oxygen pressure (PaO₂) and carbon dioxide pressure (PaCO₂). Results: FIP induction led to significant increases in plasma levels of IL-6, IL-1β, TNF-α, CRP, MDA, cGMP, and lactic acid, accompanied by elevated CT attenuation (HU) values and a marked reduction in arterial PaO₂ and PaCO₂. MB treatment significantly decreased the levels of IL-6, IL-1β, TNF-α, CRP, MDA, lactic acid, and cGMP, improved PaO₂, and attenuated both histopathological lung injury and CT-assessed parenchymal density. No significant differences were observed in PaCO₂ among the groups. Conclusions: MB mitigates inflammation, oxidative damage, and pulmonary dysfunction in FIP-induced sepsis. Further studies are warranted to optimize dosing and timing and to evaluate long-term outcomes. Full article

Background: Taekwondo (TKD) athletes’ nutritional and health statuses and body composition are critical to their physical performance and overall fitness. In Lebanon, TKD is widely practiced; however, there is a significant gap in the literature regarding the nutritional and health profiles of its athletes. This study aimed to assess the nutritional status, anemia prevalence, body composition, and other health-related characteristics, among Lebanese TKD athletes. Additionally, it explored the determinants of normal hemoglobin (Hb) levels, blood pressure, normal muscle mass, and normal fat mass. Methods: A cross-sectional study was conducted between January and July 2023, involving 110 TKD athletes. Hemoglobin and hematocrit levels were measured to assess anemia, while body composition was evaluated using a bioelectrical impedance analyzer. Blood pressure was also recorded. Household dietary diversity was assessed using the Food Consumption Score, and additional data on sociodemographic factors, training frequency, and supplement or medication use were gathered through a structured questionnaire. Logistic regression models were applied to identify predictors of normal Hb levels, hypertension, and optimal muscle and fat mass. Results: Results showed that male athletes had significantly higher rates of normal Hb (p-value = 0.013) and muscle mass percentages (p-value < 0.001), while females had higher rates of normal blood pressure (p-value = 0.002) and were more likely to use iron supplements (p-value = 0.002) and painkillers (p-value = 0.041). Normal fat mass was positively associated with normal Hb levels (aOR: 11.98, p-value = 0.033). Female gender was linked to a lower likelihood of normal muscle mass (aOR: 0.13, p-value < 0.001) and hypertension (aOR: 0.19, p-value = 0.009). Higher training duration (10 h or more per week) (aOR: 3.46, p-value = 0.04) and normal BMI (aOR: 4.93, p-value = 0.003) were positively associated with normal muscle mass. Normal BMI (aOR: 14.68, p-value < 0.001) was positively associated with normal fat mass. Conclusion: These findings underscore the importance of individualized dietary interventions to enhance athletes’ overall health and performance, through the optimization of athletes’ body composition, and the prevention of deficiencies, especially iron deficiency. Full article

Abnormal aortic elasticity serves as a marker for cardiovascular mortality and has a negative impact on the left ventricular (LV) afterload. Noncompaction cardiomyopathy (NCCM) is characterized by hypertrabeculation of the LV endomyocardial wall, with an underdeveloped endocardial helix. This may result in absence of LV twist, disturbed aortic elasticity, LV dysfunction, and ultimately premature heart failure (HF). This study compared the aortic stiffness and clinical outcome in patients with NCCM to that of a control group with dilated cardiomyopathy (DCM). Sixty NCCM patients, matched by age and sex, were compared with 60 DCM controls. Transthoracic echocardiography was performed to measure the systolic (SD) and diastolic diameters (DD) of the ascending aorta. These measurements, along with systolic (SBP) and diastolic blood pressure (DBP), were utilized to calculate the aortic stiffness index defined as ln(SBP/DBP)/[(SD-DD)/DD]. This index was then compared to clinical features and outcome. The mean age was 49 ± 16 years (55% males) in the NCCM group and 49 ± 16 years (55% male) in the DCM group. Aortic stiffness index (ASI) was significantly higher in the NCCM group than in the DCM group (7.0 [5.8–10.2] vs. 6.2 [4.8–7.7], p = 0.011). This difference remained statistically significant after adjustment for established risk factors associated with aortic stiffness (β = 1.771; 95% CI [0.253–3.289], p = 0.023). Patients with NCCM demonstrated increased aortic stiffness when compared to those with DCM, which may reflect the underlying pathophysiological processes. Additional research is necessary to evaluate the impact of aortic stiffness on the advancement of LV dysfunction, the onset of heart failure, and long-term outcomes. Full article

Background/Objectives: Esaxerenone, a novel non-steroidal mineralocorticoid receptor antagonist, has shown promising results in the treatment of essential hypertension (HTN). This study aims to comprehensively analyze the effectiveness of esaxerenone to control BP in patients with essential HTN. Methods: A systematic search was performed on PubMed, Scopus, Web of Science (WOS), and Cochrane Library from inception until January 2025 for randomized controlled trials (RCTs) comparing esaxerenone with standard HTN usual care. The primary outcome of interest was mean changes in sitting systolic (SBP) and diastolic blood pressure (DBP). Other secondary outcomes were mean changes in 24 h-SBP and 24 h-DBP, and target BP achievement. Safety outcomes, such as adverse events and increased levels of potassium/uric acid, were also assessed. Results: Our meta-analysis included four studies with a total of 1981 patients, all conducted in Japan. Esaxerenone demonstrated dose-dependent blood pressure reductions. At 5 mg, sitting DBP decreased by 4.22 mmHg (95% CI −8.72 to 0.29; p = 0.07) and SBP by 9.07 mmHg (95% CI −17.69 to −0.45; p = 0.04), while the 1.25 mg dose showed smaller, non-significant reductions. For 24 h measurements, only the 5 mg dose achieved significant reductions. Target BP achievement increased by 48% overall (RR 1.48, 95% CI 1.11 to 1.96; p = 0.007), with stronger effects at 5 mg (RR 2.05, 95% CI 1.03 to 4.08; p = 0.04). Esaxerenone significantly reduced nocturnal SBP by 10.62 mmHg (95% CI −14.01 to −7.23; p < 0.001). Conclusions: In patients with essential HTN, esaxerenone was shown to be safe and well-tolerated compared with usual care. Long-term data on safety is warranted. Full article

Blood flow restriction (BFR) training, first introduced by Dr. Yoshiaki Sato as KAATSU, has attracted increasing interest in sports science. Although the BFR training method has several additional benefits, the way occlusion pressure is identified contributes to BFR usability and safety. This study aims to develop and validate a predictive model for estimating individualized LOP with manual technique by examining the influence of blood pressure, fat percentage, limb circumference, and BMI as independent variables. A total of 158 healthy male adults participated in the study. Subjects with cardiovascular, metabolic, or musculoskeletal disorders, as well as those using supplements, medications, or nicotine, were excluded from the study. The cross-sectional study examined the correlation between the variables and derived a regression equation for predicting the corresponding LOP and anthropometric values. Three measurements were taken and the arithmetic mean was calculated from these measurements. It is evident that body mass index (BMI) emerged as a significant contributing factor in predicting limb occlusion pressure (LOP), outpacing traditional anthropometric variables such as limb circumference or body fat percentage. The regression model accounted for 18% of the variance in LOP (R² = 0.18), with a standard error of estimate (SEE) of 20.5 mmHg, suggesting moderate predictive capacity. Future work should investigate vascular factors and technological development in BFR devices for optimal pressure calibration to improve the efficacy of individualized BFR training. Full article

Objectives: The health of the adult population is the result of many interacting variables, with health behaviors and lifestyle playing a key role. This study aimed to identify associations among health-related behaviors and health and hydration status in Polish adults. Methods: The completion of a beverage frequency questionnaire (FFQ) was undertaken by a total of 337 participants. Blood pressure (BP), anthropometric parameters, and body composition were measured. Urine samples were analyzed for specific gravity (USG), osmolality (Uosm), and potential hydrogen value (pH). Health-related behaviors were assessed using the Health Index Score (HIS), classifying participants into two groups: unhealthy habits (0–2 HIS group) and healthy habits (3–5 HIS group). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: Approximately 30% of participants (n = 115) exhibited unhealthy habits. Individuals in the 0–2 HIS group were more likely to be male, smoke, have low physical activity, be overweight or obese, sleep < 6 h, and/or consume alcohol ≥ 2 times/week. In contrast, higher HIS (3–5) was associated with female gender, non-smoking, moderate-to-high physical activity, normal body mass index (BMI), adequate sleep, and consuming alcohol < 2 times/week. Fatigue during the day (OR: 1.45), waist circumference (WC) (OR: 1.35), and Uosm (OR: 1.87) increased un-healthy habits. Conversely, greater consumption of non-carbonated mineral water (OR: 0.54) was linked to lower unhealthy habits. Conclusions: The HIS and hydration-related parameters can complement the assessment of the health status of the adult population and the identification of groups requiring special support in health promotion interventions. Full article

Background: Arterial hypertension (HTN) is the leading modifiable cardiovascular risk factor for overall mortality worldwide. In Austria, 1.6 million individuals above the age of 15, representing 20% of the total population and 70% of adults aged 65 and older, suffer from HTN. Despite numerous antihypertensive treatment options on the European market, only 38.8% of patients on optimal medical treatment (OMT) reach their treatment goal. Primary prevention remains a challenge, particularly for HTN and the consequential risk of cardiovascular diseases (CVDs). Thus, there is an urgent need for Disease Management Programs (DMPs). We sought to study a possible trial to diagnose hypertension in a non-medical setting at a very early stage of the disease and raise awareness for hypertension in affected people to avoid future complications of unrecognized and untreated HTN. For a non-medical setting, hairdressers fulfil many criteria for an optimal blood pressure (BP) measurement. Methods: This is a pilot study. A total of 193 individuals were included at a Viennese hairdresser. Metric data were described either using mean ± SD given normal distribution or median otherwise. Categorical data were described using absolute frequencies and percentages. For comparison, either independent t-tests or Mann–Whitney U tests or chi² tests were assessed. The staff received expert training on how to measure blood pressure in a guideline-compliant way. All members signed the written and informed consent and received a questionnaire about their demographic data and cardiovascular risk factors. Results: Of the 193 participants in this study, 56.5% (109/193) were female and 43.5% (84/193) were male. The mean age was 54 ± 15.1 years. In the automatically measured office blood pressure (AOBP) measurement, the mean systolic BP was 137.1 ± 17.8 and the mean diastolic BP was 91.6 ± 11.2. Of all participants, 65.8% (127/193) were hypertensive, whereof 74.8% (95/127) had no treatment at all. Among 127 individuals evaluated, 63% (80/127) were unaware of their elevated blood pressure levels, while 28% (44/127) had a prior diagnosis of HTN. The control rate of the individuals with previously diagnosed HTN was very low, with only 18.5% [10.4; 30.9] reaching normotensive values in the current measurement. There was no difference in BP values of patients with previously diagnosed HTN and patients who were unaware of their disease. Antihypertensive treatment was being received by 20.2% (39/193), while 62.2% had not taken their prescribed blood pressure medication on the day of recruitment. Conclusions: This is the first Austrian study to show that screening for HTN in an unconventional non-medical setting is effective to diagnose HTN and raise awareness. Based on the even-higher-than-expected prevalence of HTN, we plan to conduct a cohort study in Vienna, inviting all hairdressers in socially deprived districts to act as gate openers for hypertensive subjects to raise awareness and to contact a regional GP for provision of medical care. An implementation of such a cost-effective and feasible disease management program in Austria might therefore reduce the burden of preventable cardiovascular events associated with HTN. Full article

The mechanisms underlying the effects of dapagliflozin in heart failure with reduced ejection fraction (HFrEF) are not yet fully understood. This study aims to evaluate the effect of the drug on cardiorespiratory function by assessing alveolar–capillary membrane characteristics, sleep apnea, pulmonary and cardiac performance in stable HFrEF patients. Seventy-three patients with stable HFrEF were enrolled, with 66 completing the six-month follow-up. Analyses included assessment of the alveolar–capillary membrane by diffusion capacity, including its membrane diffusion and capillary volume components and measurements of proSP-B in the blood, an emerging biomarker of alveolar–capillary membrane function. Pulmonary function tests, overnight respiratory monitoring, and echocardiographic parameter collection were also conducted. After 6 months, a reduction in circulating proSP-B levels was observed (32.65 ± 13.36 at baseline vs. 30.86 ± 12.45 AU at 6 months, p for trend 0.0092), accompanied by improvements in echocardiographic parameters (left ventricle ejection fraction and pulmonary pressures). Pulmonary function tests and overnight respiratory monitoring showed no significant changes in lung diffusion, spirometry, or obstructive sleep apnea (apnea hypopnea index from 5.0 [1.1–16.6] at baseline to 6.2 [0.7–13.8]/h; p = n.s.). A significant reduction in central sleep apnea (CSA) was noted in the 13 patients with at least one CSA at baseline (15 [3–48] vs. 0 [0–18.5]/h, p = 0.017). Dapagliflozin demonstrates both hemodynamic and non-hemodynamic effects, particularly improving alveolar–capillary membrane function. This study highlights the multifactorial benefits of dapagliflozin in patients with stable HFrEF and the potential of proSP-B as a sensitive marker for evaluating therapeutic response. Full article

Background: Nonadherence to antihypertensive therapy affects nearly half of treated patients worldwide, and persistence often falls below 60% within the first year, contributing substantially to uncontrolled blood pressure and cardiovascular morbidity. Adherence and persistence to antihypertensive therapy among primary care patients in Mureș County, Romania, were assessed using validated measures, and modifiable risk factors for targeted interventions were identified. Methods: A cross-sectional study of 399 hypertensive adults (≥18 years) receiving treatment for ≥1 year across primary care clinics in Mureș County, Romania, was performed. Adherence was evaluated using the Romanian-validated Hill–Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) and confirmed by mean arterial pressure (MAP) < 100 mmHg. Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal HBCTS cutoff, and multivariate logistic regression was used to identify independent predictors of adherence. Persistence was assessed via healthcare-engagement metrics over a 360-day observation period. Results: Effective blood pressure control (MAP < 100 mmHg) was achieved by 45.9% of participants. The HBCTS demonstrated good reliability (McDonald’s ω = 0.82). ROC analysis established 51 points as an optimal threshold (sensitivity = 88.0%, specificity = 38.9%). Male gender (OR = 0.47, 95% CI: 0.29–0.75, p = 0.002) and younger age (OR = 1.04 per year, 95% CI: 1.01–1.06, p = 0.001) independently predicted poor adherence. Treatment coverage days showed the strongest correlation with blood pressure control (r = −0.50, p < 0.001). Among participants, 67.7% demonstrated persistence, achieving significantly better blood pressure control than non-persistent patients. Conclusions: The validated HBCTS (≥51 points) provides an efficient screening tool for Romanian primary care settings. Treatment coverage days emerged as the strongest modifiable predictor of blood pressure control (r = −0.50), highlighting medication availability as a key intervention target. Targeted approaches for male and younger patients, combined with systematic medication continuity monitoring, represent evidence-based strategies for reducing cardiovascular morbidity in this population. Full article