Clinical and Experimental Hypertension最新文献

{"title":"Effects of time-restricted eating on blood pressure in children: A cluster randomized controlled trial.","authors":"Xiaofei Wu, Jingkun Miao, Zhilian Peng, Xizhou An, Qin Liu, Lanling Chen, Xiaohua Liang","doi":"10.1080/10641963.2026.2635384","DOIUrl":"https://doi.org/10.1080/10641963.2026.2635384","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the safety and efficacy of a time-restricted eating (TRE) intervention to reduce blood pressure (BP) in children and adolescents.</p><p><strong>Methods: </strong>We conducted a 12-month, three-arm cluster-randomized controlled trial in two schools, with classes as the unit of randomization (91 classes). Children and adolescents with elevated BP were allocated to TREa (12-hour eating window with the last meal before 8:00 PM), TREb (12-hour eating window without a fixed last mealtime), or control (no time restriction). A total of 192 participants were enrolled and analyzed under an intention-to-treat framework (64 per group). Follow-up completion (retention) rates were 65.1% (125/192) at 6 months and 59.4% (114/192) at 12 months, corresponding to loss-to-follow-up rates of 34.9% (67/192) and 40.6% (78/192), respectively. Analyses used mixed-effects models accounting for clustering, with multiple imputations as a sensitivity analysis for missing data.</p><p><strong>Results: </strong>After 12 months of intervention, both the TREa and TREb groups showed significant reductions in BP, with TREa demonstrating the most significant changes. Systolic blood pressure (SBP) decreased significantly in the TREa (-7.03 mmHg, 95%CI, -10.77 to -3.29 mmHg; <i>P</i> < 0.001) and TREb groups (-5.29 mmHg, 95%CI, -9.44 to -1.14 mmHg; <i>P</i> = 0.013). Diastolic blood pressure (DBP) changes in the TREa group were -4.09 mmHg (-6.80 to -1.38 mmHg; <i>P</i> < 0.001), with significantly different compared to the control group (<i>P</i> = 0.006).</p><p><strong>Conclusions: </strong>A 12-hour eating window, particularly with the last meal completed before 8 PM, may be associated with lower BP over 12 months in children and adolescents with elevated BP; interpretation should consider the cluster design and attrition.</p><p><strong>Trial registration: </strong>ChiCTR2400090073 (retrospectively registered on 23 September 2024).</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2635384"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertensive disorders of pregnancy: A comprehensive review of pathophysiology, diagnosis, treatment, and long-term cardiovascular implications.","authors":"Lina Fan, Lijuan Ding, Juan Nie, Jun Wang, Min Zhang, Jun Zhang","doi":"10.1080/10641963.2026.2641542","DOIUrl":"https://doi.org/10.1080/10641963.2026.2641542","url":null,"abstract":"<p><p>Hypertensive disorders of pregnancy (HDP) are common and clinically consequential, affecting ~5%-10% of pregnancies and contributing substantially to maternal and perinatal morbidity and mortality. This review summarizes key concepts that inform bedside decision-making, including contemporary classification, major pathophysiologic pathways (placental dysfunction, endothelial injury, and systemic inflammation), and diagnostic criteria to support timely recognition and risk stratification. Clinically, early identification of preeclampsia and prompt management of severe hypertension and acute complications are central to reducing preventable harm. We highlight evidence-based treatment strategies, focusing on blood pressure control, monitoring for maternal-fetal deterioration, and coordinated multidisciplinary care. Beyond pregnancy, women with prior HDP face elevated long-term cardiovascular risk; therefore, structured postpartum follow-up, cardiovascular risk assessment, and preventive interventions are essential. By integrating current guidelines with recent evidence, this article provides practical recommendations to improve short-term maternal-fetal outcomes and long-term cardiovascular health.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2641542"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic impact of nondipper heart rate and blood pressure on left ventricular hypertrophy in essential hypertension.","authors":"Bingqing Zhou, Yuanyuan Jiang, Dongyu Hu, Li He, Kunmei Chen, Li Li, Jinxin Fu, Jianlin Du","doi":"10.1080/10641963.2026.2652134","DOIUrl":"https://doi.org/10.1080/10641963.2026.2652134","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular hypertrophy (LVH) is a serious complication of hypertension. However, the association between the nondipper heart rate (NDHR) and the risk of LVH remains unclear.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted involving 991 patients with essential hypertension. NDHR was defined as a <10% reduction in nocturnal heart rate assessed by 24-h ambulatory blood pressure monitoring. Propensity score matching (PSM) was used to balance baseline characteristics. The independent association was assessed using multivariable logistic regression, and interactions were evaluated on multiplicative and additive scales.</p><p><strong>Results: </strong>After exclusions, 991 eligible hypertensive patients were included, with 234 PSM pairs of nondipper and dipper participants achieving balanced baseline characteristics. The NDHR was independently associated with LVH after multivariable adjustment (OR = 1.588 [95%CI: 1.062-2.373]; <i>P</i> = 0.024). A significant synergistic interaction was observed between NDHR and nondipper blood pressure, with the dual nondipper phenotype conferring the highest odds of LVH (OR = 2.52 [95%CI: 1.68-3.78]). Additive interaction measures confirmed biological synergy (RERI = 0.98; AP, 0.39). A nomogram incorporating NDHR demonstrated acceptable discrimination for LVH (AUC = 0.66 [95%CI: 0.61-0.71]) and provided superior net benefit across a wide threshold probability range (20%-80%). Subgroup analyses indicated stronger associations in younger patients and those not using ACEI/ARBs.</p><p><strong>Conclusion: </strong>NDHR is an independent risk factor for LVH and exhibits significant synergy with NDBP. Assessment of nocturnal heart rate decline, despite its behavioral confounders, may enhance cardiovascular risk stratification in hypertension.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2652134"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bulk and single-cell transcriptomics for identification of potential diagnostic biomarkers associated with pulmonary arterial hypertension and integrated stress response and experimental validation.","authors":"Haoran Li, Meiling Li, Chenming Qiu, Yongjian Yang, Cong Lan","doi":"10.1080/10641963.2026.2629926","DOIUrl":"https://doi.org/10.1080/10641963.2026.2629926","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) is a lethal vascular disorder characterized by irreversible remodeling of the pulmonary arteries, but the systematic role of the integrated stress response (ISR)-related genes (ISR-RGs) in its pathogenesis remains unexplored.</p><p><strong>Objective: </strong>This study aimed to identify and validate ISR-associated potential biomarkers for PAH using integrative bioinformatics, single-cell transcriptomics, and experimental approaches.</p><p><strong>Methods: </strong>We analyzed bulk RNA-seq datasets (GSE38267, GSE131793) and a single-cell RNA sequencing (scRNA-seq) dataset (GSE210248) from PAH patients and controls. A total of 529 ISR-RGs were integrated. Differential expression analysis, machine learning, and functional enrichment analyses were employed to identify potential biomarkers. A diagnostic nomogram was constructed and validated. Immune infiltration, regulatory networks, drug-gene interactions, and molecular docking were further investigated. Key cellular mechanisms were elucidated via scRNA-seq, and biomarker expression was validated using Reverse Transcription Quantitative Polymerase Chain Reaction (RT-qPCR) and Enzyme-linked immunosorbent assay (ELISA) in clinical whole blood samples.</p><p><strong>Results: </strong>We identified four ISR-related diagnostic biomarkers: ABCC4, ATM, SERPINH1, and ZBTB40. These genes showed consistent dysregulation in PAH across multiple datasets and were integrated into a nomogram with good predictive performance (hosmer-lemeshow (HL) test <i>P</i> = 0.432). Gene set enrichment analysis (GSEA) revealed their involvement in translation, neutrophil degranulation, and glucocorticoid pathways. The scRNA-seq highlighted their cell-type-specific expression in T cells and monocytes. Molecular docking identified CAMONSERTIB as a potent ATM-targeting drug (binding energy: -10.2 kcal/mol), and its therapeutic effects on pulmonary arterial hypertension were validated through both animal and cellular models. RT-qPCR and Elisa confirmed upregulation of ABCC4 and downregulation of ATM, SERPINH1 and ZBTB40 in PAH patients.</p><p><strong>Conclusions: </strong>This study identified four novel ISR-related biomarkers for PAH and elucidated their roles in immune infiltration and cellular remodeling. The findings provided new insights into PAH pathogenesis and offered potential tools for diagnosis and targeted therapy.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2629926"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between sweet food consumption and preeclampsia: Insights from an observational study and Mendelian randomization analysis.","authors":"Hua Lin, Lianqin Zheng, Xiumin Jiang, Mingyuan Huang, Huale Zhang, Qionglan Li","doi":"10.1080/10641963.2025.2612559","DOIUrl":"10.1080/10641963.2025.2612559","url":null,"abstract":"<p><strong>Background: </strong>Previous studies suggest links between sweet food consumption and metabolic conditions, but its role in preeclampsia (PE) remains unclear. This study combines a case‒control design with Mendelian randomization (MR) to explore the potential causal relationship between sweet food intake and PE.</p><p><strong>Methods: </strong>This retrospective cohort study included 1146 pregnant women from Fujian Provincial Maternity and Children's Hospital (60 with PE, 1086 controls). Dietary habits, specifically sweet food consumption (≥3 times/week), were recorded pre-delivery. Logistic regression assessed the association between sweet food intake and PE, adjusting for confounders like age, prenatal weight, blood glucose, and anemia. MR analysis used genetic variants from UK Biobank and FinnGen databases, analyzed via the inverse variance weighted (IVW) method, with sensitivity tests (MR-Egger, weighted median).</p><p><strong>Results: </strong>Frequent sweet food consumption was associated with increased PE risk in the cohort study (OR = 2.51, 95% CI: 1.46-4.44, <i>P</i> = 0.001) after adjustments. However, MR analysis found no causal link between sweet food intake and PE. Instead, a causal association between higher BMI and PE was identified (OR = 1.56, 95% CI: 1.40-1.74, <i>P</i> = 6.51 × 10^-16).</p><p><strong>Conclusion: </strong>While the case-control study linked frequent sweet food consumption to higher PE risk, MR analysis did not confirm causality. Elevated BMI, driven by excessive energy intake, emerged as a significant PE risk factor. Further research is needed to clarify dietary influences on PE and the interplay of diet, weight, and metabolic health in pregnancy.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2612559"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated circulating unsaturated fatty acids: A novel metabolic feature of coronary artery disease without traditional risk factors.","authors":"Zijian Wang, Xue Li, Tao Hu, Yongjian Yang, Cong Lan","doi":"10.1080/10641963.2026.2653747","DOIUrl":"https://doi.org/10.1080/10641963.2026.2653747","url":null,"abstract":"<p><p>Coronary artery disease (CAD) remains a major cause of global mortality. While established risk factors are targets of effective preventive interventions, a substantial proportion of CAD patients exhibit no conventional risk factors. To investigate potential metabolomic biomarkers of residual risk in such individuals, we conducted untargeted metabolomic profiling of serum from CAD patients lacking traditional risk factors using ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Comparative analysis with non-CAD controls revealed significant alterations in metabolite levels, with 43 metabolites elevated and 46 reduced in CAD patients. Notably, we observed a marked upregulation of circulating unsaturated fatty acids (UFAs) which reflects dysregulated unsaturated fatty acid biosynthesis. Pathway analysis further indicated enrichment in biosynthetic pathways of unsaturated fatty acids, implicating a potential role of dysregulated UFA metabolism in CAD pathogenesis. These altered fatty acids may act as potential biomarkers and residual risk factors for predicting CAD in individuals without conventional risk factors. Collectively, our study identifies elevated circulating UFAs as a novel metabolic signature in this patient subgroup, which may serve as a potential predictive indicator for noninvasive risk stratification and targeted prevention. To our knowledge, this is one of the initial metabolomic studies to identify UFA dysregulation in CAD patients without conventional risk factors, and the clinical utility requires further validation in larger multi-center cohorts.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2653747"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum endothelin-1 and endothelin-2 levels in healthy controls and circadian hypertension phenotypes: A comparison of dipper and non-dipper patients.","authors":"Burçin Küçüksevgili, Mehmet Tolga Dogru, Hüseyin Kandemir, Caglar Alp, Veli Küçüksevgili","doi":"10.1080/10641963.2026.2637683","DOIUrl":"10.1080/10641963.2026.2637683","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate serum endothelin-1 (ET-1) and endothelin-2 (ET-2) levels in patients with dipper and non-dipper hypertension compared to normotensive controls and to investigate the potential diagnostic value of these biomarkers in distinguishing circadian blood pressure phenotypes.</p><p><strong>Methods: </strong>This prospective case-control study included 163 participants classified into three groups based on 24-hour ambulatory blood pressure monitoring (ABPM): normotensive controls (n = 60), dipper hypertensive (n = 61), and non-dipper hypertensive (n = 42) patients. Dipper status was defined as a 10% nocturnal reduction in both systolic and diastolic blood pressure. Individuals with diabetes, established cardiovascular disease, or secondary hypertension were excluded. Serum endothelin-1 (ET-1) ET-1 and endothelin-2 (ET-2) ET-2 levels were analyzed using double-antibody sandwich ELISA kits.</p><p><strong>Results: </strong>ET-1 levels were significantly lower in dipper hypertensive patients (<i>p</i> < 0.001) compared to other groups. Conversely, ET-2 levels did not significantly differ between hypertensive phenotypes. ET-1 proved to be a strong diagnostic marker for distinguishing non-dipper hypertension (AUC = 0.830, sensitivity 83.3%, specificity 75.4%). While advanced age independently predicted the non-dipper pattern (OR = 1.101, <i>p</i> = 0.002), BMI and D-dimer were associated with the dipper phenotype.</p><p><strong>Conclusion: </strong>This study identifies serum endothelin-1 is a strong, independent marker of the non-dipper hypertensive phenotype, which is associated with increased cardiovascular risk. The preservation of low endothelin-1 levels in dipper hypertension patients reflects intact endothelial and circadian regulation, whereas the absence of this response in non-dipper patients indicates impaired vascular adaptation. The inverse association of endothelin-2 with non-dipper status further suggests a protective buffering role that may be attenuated by increasing metabolic burden.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2637683"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of carotid body size with left atrial strain and peripheral hemodynamics in patients with hypertension: An exploratory study.","authors":"Selen Eşki, Hatice Taşkan, Sanan Allahverdiyev, Salim Yaşar, Murat Çelik","doi":"10.1080/10641963.2026.2621676","DOIUrl":"https://doi.org/10.1080/10641963.2026.2621676","url":null,"abstract":"<p><strong>Background: </strong>The carotid body (CB) is a key regulator of sympathetic tone, and its overactivity is implicated in the pathogenesis of neurogenic hypertension. While structural enlargement of the CB may reflect chronic autonomic dysregulation, its association with early markers of hypertension-mediated organ damage (HMOD) remains insufficiently characterized.</p><p><strong>Objective: </strong>This exploratory study investigated whether carotid body size is associated with subclinical cardiac remodeling and peripheral vascular resistance in hypertensive patients.</p><p><strong>Methods: </strong>We analyzed 49 patients with hypertension who underwent carotid computed tomography angiography (CTA) and comprehensive cardiovascular phenotyping. CB diameter was measured via CTA, and patients were categorized into Group 1 (CB < 2.5 mm, <i>n</i> = 22) and Group 2 (CB ≥ 2.5 mm, <i>n</i> = 27). Cardiac mechanics were assessed using two-dimensional speckle-tracking echocardiography (2DSTE), and hemodynamic parameters were evaluated via oscillometric pulse wave analysis.</p><p><strong>Results: </strong>Despite similar peripheral systolic and central blood pressure levels, Group 2 demonstrated significantly impaired left atrial (LA) mechanics and higher vascular resistance. Specifically, Group 2 had lower LA global peak atrial longitudinal strain (PALS) (23.88 ± 7.70% vs. 30.84 ± 11.40%, <i>p</i> = 0.014) and higher total vascular resistance (TVR) (1.56 ± 0.49 vs. 1.22 ± 0.18 s⋅mmHg/mL, <i>p</i> < 0.001) compared to Group 1. Augmentation index normalized to 75 bpm (AIx@75) was also elevated in the CB enlargement group (31.11 ± 7.91% vs. 24.36 ± 11.77%, <i>p</i> = 0.021). In multivariate linear regression analysis, LA diameter, TVR, and urinary microalbumin-to-creatinine ratio were independent determinants of CB size (Adjusted R² = 0.429, <i>p</i> = 0.022).</p><p><strong>Conclusion: </strong>Carotid body enlargement is associated with impaired left atrial strain parameters and increased peripheral vascular load in patients with hypertension. These findings suggest that CB morphology may serve as a potential marker for early subclinical cardiovascular and renal alterations, reflecting a distinct neurovascular phenotype in hypertension.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2621676"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms linking hypertension to cardiovascular and cerebrovascular diseases and their clinical implications: A comprehensive review.","authors":"Guangya Li, Jing Jing Zhang, Xiaojie Mou, Xin Zhuo, Weikai Li, Shenghao Zhang, Shuang Qi, Xiubin Li","doi":"10.1080/10641963.2026.2631606","DOIUrl":"https://doi.org/10.1080/10641963.2026.2631606","url":null,"abstract":"<p><p>Hypertension, one of the most prevalent chronic conditions worldwide, stands as a principal risk factor for cardiovascular and cerebrovascular diseases, including coronary heart disease and stroke. Recent advances have clarified a graded, dose-response relationship in which higher blood pressure is consistently associated with increased vascular event risk, with relative risks commonly ranging from modest elevations (~1.2) at the lower end of above-optimal blood pressure to substantially higher levels (>3.0) in more severe hypertension categories. This review synthesizes current evidence on how hypertension influences the incidence and progression of cardiovascular and cerebrovascular diseases, emphasizing its interplay with comorbid conditions such as obesity, metabolic syndrome, pregnancy-induced hypertension, and sleep apnea. Additionally, it explores the impact of blood pressure management targets on the prevention of adverse vascular events and evaluates the safety and efficacy of pharmacological treatments in diverse patient populations. Environmental contributors and their role in modulating disease risk are also addressed. By integrating epidemiological data with clinical research findings, this article aims to provide a comprehensive theoretical framework and practical guidance for the prevention and management of cardiovascular and cerebrovascular complications in hypertensive patients.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2631606"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure variability: From predictive marker to intervention target-breaking the vicious cycle of hypertensive target organ damage.","authors":"Ruiqin Luo, Ying Huang, Yanjun Leng, Weiqian Liao","doi":"10.1080/10641963.2025.2601054","DOIUrl":"https://doi.org/10.1080/10641963.2025.2601054","url":null,"abstract":"<p><p>Hypertensive target organ damage (TOD) is a pivotal driver of cardiovascular events and mortality. Despite widespread control of traditional blood pressure (BP) averages, TOD progression persists in some patients, underscoring the independent and significant role of blood pressure variability (BPV). Accumulating evidence has established BPV not only as an independent predictor of TOD risk but also as an active contributor to its pathogenesis by propelling the vicious cycle of \"hypertension-arteriosclerosis.\" This article systematically reviews the epidemiological evidence supporting BPV as an independent risk factor, elucidates its mediating pathways through mechanisms such as endothelial dysfunction, inflammatory activation, and arterial stiffness, and discusses recent advances and future directions in precision management strategies focused on attenuating BPV. This review aims to provide a novel theoretical basis and practical guidance for risk assessment and individualized treatment in hypertension. We advocate shifting the clinical paradigm from solely targeting mean BP to integrating BPV control into a comprehensive management strategy. This integrated approach is critical for disrupting the vicious cycle of TOD and achieving effective prevention of cardiovascular events.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"47 1","pages":"2601054"},"PeriodicalIF":3.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}