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Accumulating evidence indicates that higher levels of salt intake are associated with higher blood pressure levels. The aim of our analysis was to test the hypothesis that the effect of urinary sodium excretion (UNaV) on systolic blood pressure (SBP) is mediated through estimated glomerular filtration rate (eGFR) and arterial stiffness and also to test the direction of the relationship between eGFR and arterial stiffness, in both hypertensive and normotensive patients. We assessed the potential for connection between UNaV and SBP and mediators (eGFR and pulse wave velocity [PWV]) of this relationship using structural equation models of data from 1599 adults ≥18 years of age and without chronic kidney disease who participated in the Third Epidemiologic Study concerning the Prevalence of Arterial Hypertension and Cardiovascular Risk in Romania (SEPHAR III). In hypertensive patients, the indirect effect, mediated through PWV, of UNaV on SBP was 23.9% and 27.7% of the total effect of UNaV on SBP, while in normotensive patients the contribution of PWV to the total effect of UNaV on SBP was slightly lower (15.9% and 18.3% of the total effect of UNaV on SBP). Taken together, our findings support the conclusion that UNaV influences SBP, both directly and indirectly, through the effect on PWV. [ABSTRACT FROM AUTHOR]

Purpose: The present study aims to analyse the past and future trend in HT's prevalence, awarness, treatment and control in adult Romanian population using statistical models based on the results of the three national-representative surveys. Methodology: using the data from the three national-representative surveys: SEPHAR I, II and III conducted between 2005 and 2016, by means of Simple exponential smoothing and Brown linear smoothing analysis using IBM SPSS 20.0 software we evaluated the past in future trend (up to year 2020) of hypertension's prevalence, awareness, treatment and control in our adult population. Main fi ndings: The evolution of HT's prevalence is characterized by significant oscillations in the analysed period (2005-2016) and in 2020, is estimated to be 44%. Awareness of hypertension followed a steady trend of growth from 2005 to 2016. If in 2005 the percentage of hypertensive aware of their condition was 44.3%, in 2016 their percentage reached 80.9%, being expected to increase up to 96.2% in 2020. The percentage of treated hypertensives increased to 59.2% in 2012 and 75.2% in 2016, and is expected to reach 91.2% in 2020 unless there are major events at the level of risk factor changes. In 2005, BP control rate was 19.9%, percentage which rose to 30.8% in 2016 and is expected to increase up to 36.6% by year 2020. Conclusions: Based on the results of our study, in Romania, hypertension's prevalence has increased in the last 11 years and will continue on an upward trend, if no preventive strategies at population level will be implemented in the near future. Although being on a positive trend for HT's awareness, treatment and control, hypertension management will remain suboptimal in Romania in the future, if all the influencing conditions remain, on average, similar to previous years, leading to a continuous up-ward trend in cardiovascular mortality in our country. [ABSTRACT FROM AUTHOR]

Objectives - To estimate the prevalence of high normal blood pressure (HNBP) and to find if subjects with HNBP have more often other cardiovascular risk factors. Methods - A representative sample of 1970 Romanian adults was enrolled in SEPHAR III survey. Blood pressure measurements were performed according to current guidelines and all subjects were evaluated by a 71-item survey questionnaire together with extensive evaluation for target organ damage. Results - Prevalence of HNBP was 11% [45.1% high blood pressure (HBP), 43.9% normal blood pressure (NBP)]. Values of weight, waist circumference, body mass index, total and LDL cholesterol, triglycerides, fasting blood glucose, glycosylated hemoglobin - HbA1c, uric acid, serum creatinine, glomerular filtration rate estimate by CKD-EPI Equation, albumin/creatinine ratio, intimae-media thickness, rates of arterial stiffness and diastolic dysfunction, left ventricular mass, interventricular septum and posterior left ventricle wall thickness, left atrial volume and dilatation were significantly highest in HNBP subjects than in NBP. Conclusions - Subjects with HNBP represent ~11% of the population and most of thems had an elevated cardiovascular risk. It's essential to educate the general public and health care providers to be aware of these individuals and of steps that should be taken to treat modifiable cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

One of the challenges faced when conducting a clinical trial is the recruitment of the proposed number of participants. Accordingly, identifying barriers to patients' enrollment and developing effective strategies to overcome them is mandatory. One of the main strategies employed to improve participation rate consists of designing the informed consent forms based on patients' feedback. This survey aims to explore the attitude of patients admitted in a Romanian tertiary cardiology center to take part in biomarker-based clinical trials. This is a descriptive, prospective and longitudinal single-center study. Participants will be recruited until the planned sample size will be reached (n=333). The patients will be interviewed based on a semi-structured questionnaire which includes four sections: demographics (7 items), personal medical history (7 items), attitudes (9 items) and trust (4 items). Descriptive statistics will be used to illustrate patients' demographics, medical history, attitudes toward biomarker-based clinical trials and trust in medical researchers. Logistic regression models will be employed to assess relations between patients' attitudes, trust, and different socio-demographic variables. Data analysis will offer answers to key questions addressed by this survey: What amount of and in what form should information be disclosed? Who should make the invitation to participate? The information gained will facilitate tailoring informed consent forms to suit the needs of patients with various demographic, social and educational backgrounds.

Objectives: This paper aims to evaluate the association between serum uric acid (SUA) levels, arterial hypertension (HT) prevalence, blood pressure values control, kidney function and intima media thickness (IMT), as a surrogate marker of early atherosclerosis, in a representative group of Romanian adult population., Materials and Methods: The study sample consists in 1920 adults included in SEPHAR III (Study for the Evaluation of Prevalence of Hypertension and cArdiovascular Risk in Romania) survey (mean age 48.63 years, 52.76% females) collecting data for SUA levels, blood pressure (BP) measurements, kidney function by estimated glomerular filtration rate (eGFR) and carotid IMT. SUA levels between 2,40-5,70mg/dl in females and 3,40-7,00mg/dl in males respectively were considered normal. HT and HT control were defined according to the current guidelines. IMT evaluation was assessed by B-mode Doppler ultrasound evaluation., Results: Hypertensive subjects had significantly higher values of SUA compared with normotensive subjects, hypertensive patients were 1.713 times more likely to have higher values of SUA. Among treated hypertensive patients, those without optimal BP control had significantly higher SUA levels compared with those with optimal BP control, the presence of hyperuricemia increasing the odds of suboptimal BP control by 1.023. Hyperuricemic subjects had significantly lower eGFR values compared with normouricemic ones, on an average with 14.28ml/min/1.73m2 by Modification of Diet in Renal Disease formula (MDRD) and with 16.64ml/min/1.73m2 by Chronic Kidney Disease Epidemiology Collaboration formula (CKD-EPI), with an indirect association between SUA levels and eGFR values (rs = -0.319 / -0.347), independent of age. IMT values recorded in hyperuricemic subjects were significantly increased, on an average with 0.08mm, compared with normouricemic subjects, with a direct association between SUA levels and IMT values (rs = 0.263), independent of BP values., Conclusion: The results of our study offers support that increased SUA levels are associated with arterial hypertension and with suboptimal BP control in treated hypertensive subjects. The decline in kidney function, independent of age, and also increased IMT values as a marker of atherosclerosis, were also correlated with elevated SUA values. Hyperuricemia screening may have a role in identifying patients at risk of developing HT and lowering SUA levels may improve not only BP control in treated HT patients but also decrease total cardiovascular mortality by slowing the progression of atherosclerosis and renal failure in hypertensive patients., Competing Interests: The authors have declared that no competing interests exist.