Clinical and Experimental Hypertension最新文献

{"title":"Inter-ankle systolic blood pressure difference is associated with microalbuminuria in non-diabetic hypertension patients: A cross-sectional study from two cohorts.","authors":"Yuanyuan Shi, Pengjie Gao, Xingyue Lin, Molei Zhang, Danni Wang, Kamila Kamili, Xiyang Li, Suining Xu, Gang Tian","doi":"10.1080/10641963.2026.2712543","DOIUrl":"https://doi.org/10.1080/10641963.2026.2712543","url":null,"abstract":"<p><p>This cross-sectional study aimed to analyze whether inter-ankle systolic blood pressure difference (sIAND) was associated with different stages of hypertensive renal damage. 1,658 and 831 nondiabetic hypertensive patients were included from two cohorts. The hypertensive renal damage was reflected by urinary albumin-to-creatinine ratio (UACR), Cystatin C, and estimated glomerular filtration rate. Logistic regression results showed that sIAND was only associated with subclinical hypertensive renal damage reflected by microalbuminuria (UACR > 30 mg/g) independently. Receiver operating characteristic curves indicated sIAND can identify microalbuminuria more effectively. sIAND can aid in identifying microalbuminuria to provide useful clues for risk stratification and clinical management.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2712543"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668535","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":"Electroacupuncture in hypertension-mediated organ damage: A hypothesis-generating framework of blood pressure-dependent and candidate blood pressure-independent mechanisms.","authors":"Jing Pang, Kunpeng Xia, Yihong Ma","doi":"10.1080/10641963.2026.2728373","DOIUrl":"https://doi.org/10.1080/10641963.2026.2728373","url":null,"abstract":"<p><strong>Background: </strong>Contemporary hypertension management increasingly emphasizes hypertension-mediated organ damage (HMOD) rather than blood pressure (BP) targets alone. Electroacupuncture (EA) has been studied mainly as a non-pharmacological antihypertensive intervention, but whether its reported organ-level effects reflect BP lowering or additional tissue-level mechanisms remains unclear.</p><p><strong>Methods: </strong>This narrative mechanistic review synthesized preclinical and clinical literature from PubMed, Web of Science, Scopus and CNKI to organize EA-related evidence within a dual-pathway framework distinguishing BP-dependent from candidate BP-independent mechanisms across the brain, heart, kidney and vasculature.</p><p><strong>Results: </strong>Preclinical evidence, mainly from spontaneously hypertensive rats, suggests that EA attenuates central sympathetic outflow, modulates brainstem-hypothalamic autonomic circuits, downregulates systemic and tissue renin-angiotensin-aldosterone system signaling, and reduces oxidative stress and inflammation. Organ-level evidence is graded moderate, and is the most developed of the four domains, for cardiac remodeling, including left ventricular hypertrophy and myocardial fibrosis; it is low-to-moderate for conduit-artery vascular changes and low for renal and cerebral effects. Across available studies, BP reduction and favorable organ-level changes occur together. No study has used BP-matched controls to isolate a BP-independent component, and no human trial with validated organ-specific HMOD endpoints was identified.</p><p><strong>Conclusion: </strong>Current evidence supports a hypothesis-generating dual-pathway framework in which EA-related organ effects may arise through BP-dependent mechanisms and candidate BP-independent tissue-level pathways. However, BP-independent organ protection remains unproven and requires BP-matched preclinical designs and sham-controlled human trials using validated HMOD surrogate endpoints.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2728373"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918710","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":"The ApoB/ApoA-I ratio supersedes conventional lipids in predicting coronary artery disease and clinical phenotypes requiring revascularization.","authors":"Yuanyuan Jiang, Li He, Dongyu Hu, Kunmei Chen, Li Li, Jinxin Fu, Bingqing Zhou","doi":"10.1080/10641963.2025.2603463","DOIUrl":"https://doi.org/10.1080/10641963.2025.2603463","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the apolipoprotein B (ApoB) to apolipoprotein A-I (ApoA-I) ratio as a biomarker for coronary heart disease (CHD) and its clinical phenotypes, beyond traditional lipid parameters.</p><p><strong>Methods: </strong>This single-center, case-control study analyzed 7,277 patients undergoing coronary angiography. Multivariable logistic regression assessed the independent association of the ApoB/ApoA-I ratio with CHD, acute myocardial infarction (AMI), multivessel disease (MVD), and percutaneous coronary intervention (PCI). Predictive performance was evaluated via ROC curve analysis, with prespecified subgroup analyses.</p><p><strong>Results: </strong>The ApoB/ApoA-I ratio was the strongest independent lipid predictor of CHD (adjusted OR 4.49, 95% CI 1.98-10.19). It significantly predicted severe clinical phenotypes: AMI (OR 1.94, 95% CI 1.44-2.62), MVD (OR 1.67, 95% CI 1.24-2.26), and PCI requirement (OR 1.95, 95% CI 1.43-2.66). The ratio showed significant discriminatory power for all endpoints (AUCs 0.569-0.608). Subgroup analyses revealed markedly stronger associations in males, older adults (≥60 years), and hypertensive patients, but substantially attenuated predictive value in diabetic patients.</p><p><strong>Conclusion: </strong>The ApoB/ApoA-I ratio is a superior biomarker for CHD risk stratification, particularly for identifying severe disease manifestations and guiding revascularization decisions in specific patient subgroups. Its integration into clinical practice could enable more precise cardiovascular risk management.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2603463"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809604","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":"Comparative analysis of inflammatory and metabolic indices (HALP score, NLR, LMR, and TyG index) in healthy individuals, dipper, and non-dipper hypertensive phenotypes.","authors":"Huseyin Kandemir, Caglar Alp","doi":"10.1080/10641963.2026.2657358","DOIUrl":"10.1080/10641963.2026.2657358","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the metabolic and inflammatory profiles of dipper and non-dipper hypertensive patients versus healthy controls, specifically evaluating the Triglyceride-glucose (TyG) index's association with nocturnal blood pressure patterns.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study included 325 participants (110 normotensive controls, 106 dipper hypertensive, and 109 non-dipper hypertensive). Circadian blood pressure phenotypes were defined using 24-hour ABPM according to the 2024 ESC Hypertension Guidelines. Inflammatory indices (NLR, LMR, and HALP score) and the TyG index were calculated from fasting blood samples.</p><p><strong>Results: </strong>Hypertensive groups had higher BMI and waist circumference than controls (<i>p</i> < 0.001). HALP, NLR, and LMR did not differ between the cohorts (<i>p</i> > 0.05). The TyG index showed the greatest intergroup variation and was strongly associated with the non-dipper phenotype (OR = 3.6, <i>p</i> = 0.004). TyG was positively correlated with nocturnal SBP/DBP and negatively correlated with nocturnal SBP decline. It showed significant diagnostic performance for hypertension and non-dipper status (AUC 0.667-0.696, <i>p</i> < 0.001), but limited accuracy for classifying hypertensive subgroups (AUC = 0.573, <i>p</i> = 0.064).</p><p><strong>Conclusion: </strong>The TyG index serves as a significant independently associated with the non-dipper hypertension phenotype, reflecting predominant metabolic and cardio-renal stress rather than cellular inflammation. These findings suggest that clinical management should extend beyond blood pressure control to include early optimization of insulin resistance and atherogenic lipid imbalance. Ultimately, the TyG offers a practical and cost-effective clinical tool for multidimensional cardiometabolic and cardio-renal risk assessment.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2657358"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662261","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":"Genetic determinants of hypertension: A meta-analysis of <i>AGTR1</i> and <i>CYP11B2</i> gene polymorphisms.","authors":"Sheena Mariam Thomas, Anu Shibi Anilkumar, Ramakrishnan Veerabathiran","doi":"10.1080/10641963.2026.2643329","DOIUrl":"10.1080/10641963.2026.2643329","url":null,"abstract":"<p><strong>Background: </strong>Hypertension, or high blood pressure, is a long-lasting condition caused by sustained high blood pressure in the arteries. The increase and decrease of blood pressure is greatly affected by both dietary and physiological factors. Hence, hypertension may pose serious risks of developing multiple disorders, such as heart and vascular disorders and diabetes, since it is usually not detected for a long time, and thus, it can even speed up the development of some diseases.</p><p><strong>Objective: </strong>To examine how hypertension risk is related to the variants of the genes <i>AGTR1</i> (rs5186) and <i>CYP11B2</i> (rs1799998).</p><p><strong>Methods: </strong>The meta-analysis led us to search PubMed, Embase, ScienceDirect, NCBI, and Google Scholar for studies relevant to our objective. Case‒control analyses that identified a correlation between the mentioned SNPs and hypertension and provided sufficient data for OR (odds ratio) calculation were included. The rigor of the methodology was assessed using the Newcastle‒Ottawa Scale (NOS) and Hardy‒Weinberg equilibrium (HWE).</p><p><strong>Results: </strong>In total, 10 studies on AGTR1 (rs5186) and 12 on CYP11B2 (rs1799998) were considered. The polymorphism was examined for a correlation with hypertension risk under all genetic models (allelic, dominant, recessive, or overdominant), but no association was observed. Moreover, no significant findings were obtained from the analysis of publication bias and sensitivity testing.</p><p><strong>Conclusion: </strong>The <i>AGTR1 rs5186 and CYP11B2 rs1799998</i> polymorphisms did not show a statistically significant association with hypertension predisposition. A comprehensive study would be necessary to delineate the complex genetic landscape of hypertension.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2643329"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431015","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":"Preliminary study of individualized therapy for ventricular septal defect with severe pulmonary arterial hypertension.","authors":"Weijie Tang, Jinzhou Cai, Shibiao Zhang, Yichen Li, Mi Tang, Zilong Zheng, Zhi Tu, Xiuneng Li, Chengzhi Xu, Wangping Chen, Chengming Fan, Jinfu Yang","doi":"10.1080/10641963.2026.2734004","DOIUrl":"https://doi.org/10.1080/10641963.2026.2734004","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) is a serious complication of congenital heart disease (CHD) with a left-to-right shunt, particularly ventricular septal defect (VSD). In patients presenting with severe PAH, therapeutic decision-making remains challenging because precise and individualized assessment criteria are lacking. In current clinical practice, treatment strategies are often based mainly on isolated hemodynamic parameters obtained by right heart catheterization (RHC), which may not fully reflect disease severity or reversibility.</p><p><strong>Objectives: </strong>This study aimed to explore an individualized treatment strategy for patients with severe VSD-PAH by analyzing the relationships among peripheral arterial oxygen saturation (SaO₂), pulmonary vascular resistance (PVR), pulmonary-to-systemic blood flow ratio (Qp/Qs), and pulmonary-to-systemic pressure ratio (Pp/Pa).</p><p><strong>Methods: </strong>We retrospectively analyzed 121 patients with isolated VSD and severe PAH admitted to our center between 2010 and 2020. All patients underwent RHC. Correlations between SaO₂ and PVR, Qp/Qs, and Pp/Pa were assessed using Spearman correlation analysis. Patients were stratified according to SaO₂ levels, and treatment strategies were compared across different hemodynamic profiles using Fisher's exact test. Based on these findings, we established a scoring system integrating SaO₂, PVR, Qp/Qs, and Pp/Pa, and categorized total scores to examine their association with actual treatment strategies.</p><p><strong>Results: </strong>The distribution of treatment strategies differed significantly across combinations of SaO₂ and PVR, whereas Qp/Qs and Pp/Pa provided limited additional discrimination when SaO₂ exceeded 93%. The proposed scoring system was associated with observed treatment patterns: patients with total scores ≥ 60 were predominantly managed surgically (with or without preoperative medical therapy), whereas those with scores <40 were mainly treated with medical therapy alone (93.7%). Intermediate score ranges were associated with mixed treatment patterns.</p><p><strong>Conclusions: </strong>Combining SaO₂ with RHC-derived parameters provides a more comprehensive and individualized assessment of disease severity in VSD-PAH than hemodynamics alone. The proposed multidimensional scoring system may provide a hypothesis-generating framework for cardiovascular specialists.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2734004"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104947","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":"Glycyrrhetinic acid ameliorates chronic heart failure via the Nrf2 pathway.","authors":"Ruilei Zhang, Hou Zhang, Pengli Chen, Enwen Xu, Xueqi Li, Shiguang Li","doi":"10.1080/10641963.2025.2607404","DOIUrl":"https://doi.org/10.1080/10641963.2025.2607404","url":null,"abstract":"<p><strong>Objective: </strong>To explore the mechanism by which glycyrrhetinic acid (GA) alleviates chronic heart failure (CHF), focusing on NR3C1-mediated regulation of Nrf2 and oxidative stress.</p><p><strong>Methods: </strong>A CHF rat model was established via transverse aortic constriction and treated with GA or NR3C1 knockdown. Cardiac function, hypertrophy, fibrosis, and oxidative stress markers were evaluated. <i>In vitro</i>, H9c2 cells were treated with isoproterenol to mimic CHF and subjected to GA, Nrf2 inhibitor, or NR3C1 modulation. Gene/protein expression, ROS, GSH, MDA, and mitochondrial membrane potential were assessed. Regulatory interactions between NR3C1 and Nrf2 were examined using luciferase, ChIP-qPCR, and CHX assays.</p><p><strong>Results: </strong>GA alleviated myocardial hypertrophy and fibrosis in CHF rat models. GA also suppressed oxidative stress in CHF cell models. GA upregulated Nrf2 and its downstream target HO-1 at the protein level. NR3C1 was identified as a key upstream regulator of Nrf2, promoting its protein stability. NR3C1 knockdown decreased Nrf2 and HO-1 protein expression, disrupted mitochondrial membrane potential, and weakened the protective effects of GA against oxidative stress and cardiac dysfunction both <i>in vitro</i> and <i>in vivo</i>.</p><p><strong>Conclusion: </strong>GA alleviates CHF by enhancing NR3C1-mediated stabilization of Nrf2 and reducing oxidative stress.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2607404"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827051","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":"Does hydrochlorothiazide-associated hyponatremia in hypertensive individuals have a genetic origin?","authors":"Gulsum Ozkan, Caner Celik, Hilmi Tozkir, Semih Asıkovali, Nergiz Bayrakci","doi":"10.1080/10641963.2026.2702343","DOIUrl":"10.1080/10641963.2026.2702343","url":null,"abstract":"<p><strong>Objective: </strong>Hyponatremia is one of the most common electrolyte disorders in clinical practice and is frequently observed following thiazide use. Advanced age and female gender are implicated in the etiology of hydrochlorothiazide (HCTZ)-associated hyponatremia. There has also recently been mention of a genetic disposition. This study evaluated the genetic component, and particularly the clinical significance, of variants in the <i>SLC12A3</i> gene in the development of hyponatremia in hypertensive patients using HCTZ-group diuretics.</p><p><strong>Method: </strong>Ninety-five patients presenting to the Tekirdağ Namık Kemal University nephrology clinic and receiving antihypertensive therapy including HCTZ for at least one month were examined. Peripheral blood specimens were collected from hyponatremic (<i>n</i> = 62) and non-hyponatremic (<i>n</i> = 33) individuals. Variants in the <i>SLC12A3</i> gene were analyzed using next generation sequencing and were compared with the clinical data.</p><p><strong>Results: </strong>A total of 947 variants were detected in the <i>SLC12A3</i> gene, the majority of which were classified as of uncertain significance. Hyponatremia was determined at a higher rate in patients with c.506-276A>G (75.00%), c.282+492G>A (85.70%), c.282+499G>C (87.00%), c.282+495G>A (85.00%), and c.505+375G>A (92.30%) variants in particular. The risk of hyponatremia development increased 9.2-fold in the presence of the c.282+492G>A variant (OR = 9.243; 95% CI: 2.259-37.818; <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>In conclusion, we think that HCTZ-associated hyponatremia cannot be predicted by clinical and biochemical parameters alone, and that genetic factors should also be considered. Further multi-center prospective studies involving larger populations will clarify the clinical significance of variants in <i>SLC12A3</i> and other genes and will make a significant contribution to individualized therapeutic approaches.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2702343"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444394","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":"Clinical implications of aldosterone responsiveness to adrenocorticotropic hormone stimulation in two major subtypes of primary aldosteronism.","authors":"Daisuke Watanabe, Satoshi Morimoto, Noriko Morishima, Atsuhiro Ichihara","doi":"10.1080/10641963.2026.2637682","DOIUrl":"10.1080/10641963.2026.2637682","url":null,"abstract":"<p><strong>Objective: </strong>This study examined differences in aldosterone responsiveness to adrenocorticotropic hormone (ACTH) between the unilateral aldosterone-producing adenoma (APA) and bilateral idiopathic hyperaldosteronism (IHA) subtypes of primary aldosteronism (PA) and the impacts on vascular function and treatment outcomes.</p><p><strong>Methods: </strong>This retrospective study enrolled 97 patients with PA (63 with APA and 34 with IHA) who underwent adrenal venous sampling (AVS) with ACTH stimulation. During AVS, baseline and ACTH-stimulated plasma aldosterone concentration (PAC) and cortisol levels were also assessed. Vascular function was assessed by measuring flow-mediated dilation (FMD). APA tissues were analyzed for <i>KCNJ5</i> mutations.</p><p><strong>Results: </strong>Among 97 patients with PA, those with APA showed higher baseline and ACTH-stimulated plasma aldosterone concentration levels, which correlated inversely with FMD. In patients with IHA, the logarithmic difference between PAC measurements before and after ACTH stimulation correlated positively with the blood pressure-normalization effect after mineralocorticoid receptor antagonist (MRA) therapy, with a cutoff value of 2.140 for predicting treatment response.</p><p><strong>Conclusion: </strong>These findings suggest that ACTH-stimulated aldosterone may offer a useful marker for personalized management of PA, particularly in assessing vascular health and guiding MRA treatment.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2637682"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316219","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":"Cardiometabolic index and advanced cardiovascular-kidney-metabolic syndrome in two population-based cohorts from the USA and China.","authors":"Huatao Zhou, Desong Yang, Wenxiang Wang, Chengming Fan","doi":"10.1080/10641963.2026.2652127","DOIUrl":"10.1080/10641963.2026.2652127","url":null,"abstract":"<p><strong>Background: </strong>The cardiometabolic index (CMI) integrates central adiposity with atherogenic dyslipidaemia and may identify individuals at elevated cardiometabolic risk. However, evidence linking CMI to advanced cardiovascular-kidney-metabolic (CKM) syndrome across diverse populations remains limited.</p><p><strong>Methods: </strong>We conducted cross-sectional analyses on adults aged ≥ 45 years using data from NHANES (2001-2018) and CHARLS (2011/2015). CMI was calculated as (triglycerides/HDL-cholesterol) × (waist/height). The primary outcome was advanced CKM (stages 3-4). Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines and two-piecewise regression assessed non-linearity and thresholds.</p><p><strong>Results: </strong>The analytic sample included 10,198 participants from NHANES and 17,285 from CHARLS. Higher CMI was independently associated with advanced CKM (NHANES: OR 1.35, 95% CI 1.15-1.57; CHARLS: OR 1.86, 95% CI 1.70-2.04). In quartile analyses, the highest CMI quartile demonstrated the strongest associations compared to the lowest (NHANES: OR 1.72, 95% CI 1.30-2.26; CHARLS: OR 3.33, 95% CI 2.85-3.89). While the relationship was linear in NHANES, it was non-linear in CHARLS (<i>P</i> < 0.001), with a threshold effect at CMI = 0.509. Below this threshold, risk increased sharply (OR 3.879, 95% CI 2.137-7.040), whereas above it, the association was attenuated but remained significant (OR 1.528, 95% CI 1.360-1.717).</p><p><strong>Conclusions: </strong>CMI was associated with an increased risk of advanced CKM in two large, nationally representative cohorts. These findings support the potential utility of CMI in risk stratification. Future prospective studies are needed to confirm its predictive value and define clinically relevant thresholds.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2652127"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580680","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}