Clinical and Experimental Hypertension最新文献

{"title":"CQ essential hypertension classification: The comprehensive classification to facilitate precise therapy.","authors":"Ken Chen, Chunyu Zeng","doi":"10.1080/10641963.2026.2725250","DOIUrl":"https://doi.org/10.1080/10641963.2026.2725250","url":null,"abstract":"","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2725250"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863859","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":"Presenting non-insulin-based indices of insulin resistance relevant to pre-hypertension: A systematic review and meta-analysis.","authors":"Maryam Farahmand, Sima Nazarpour, Hanieh Malmir, Somayeh Hosseinpour-Niazi, Fahimeh Ramezani Tehrani","doi":"10.1080/10641963.2026.2625124","DOIUrl":"10.1080/10641963.2026.2625124","url":null,"abstract":"<p><strong>Background: </strong>Using reliable, simple, and cost-effective tools to identify pre-hypertension (pre-HTN) early is crucial for reducing the risk of cardiovascular disease (CVD). This systematic review and meta-analysis aimed to assess the association between the risk of pre-HTN and non-insulin-based indices.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across electronic databases, including PubMed, Web of Science, and Scopus, until January 2025. Cross-sectional studies investigating the relationship between pre-HTN and IR indices were included. Two investigators independently performed study screening, data extraction, and quality assessment. A random-effects model was used to pool effect sizes, with odds ratios (ORs) as the primary measure of effect.</p><p><strong>Results: </strong>Overall, 15 studies met the inclusion criteria for this systematic review, and 14 were included in the meta-analysis. All were cross-sectional or employed a cross-sectional approach. The results of the random effects model showed that IR indices, including the fasting triglyceride and glucose index-to-body mass index (TyG-BMI), fasting triglyceride and glucose index-to-waist circumference (TyG-WC), triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), metabolic score for insulin resistance (METS-IR), and fasting triglyceride and glucose index (TyG), increased the odds of pre-HTN significantly (<i>P</i> < 0.05). The diagnostic odds ratios (DORs) were 2.67 (95% CI: 2.39-2.97) for TyG and 3.45 (95% CI: 2.73-4.35) for TyG-BMI.</p><p><strong>Conclusions: </strong>This meta-analysis reveals that non-insulin-based IR indices are associated with a higher risk of pre-HTN. However, given the cross-sectional design of all included studies, a causal relationship cannot be inferred. As cost-effective and user-friendly tools, they could aid in the early detection and prevention of HTN, but further prospective and longitudinal research is needed to confirm these findings and establish causality.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2625124"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117611","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":"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":6.8,"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":"Commentary on \"Electroacupuncture for essential hypertension: mechanistic insights, current clinical evidence, and translational challenges\".","authors":"Anamika Rajpoot","doi":"10.1080/10641963.2026.2708005","DOIUrl":"https://doi.org/10.1080/10641963.2026.2708005","url":null,"abstract":"","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2708005"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590745","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":"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":6.8,"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":"Association of blood pressure dipping status with Naples Prognostic Score and arterial stiffness in newly diagnosed hypertensive patients.","authors":"Muhammed Ulvi Yalcin, Kadri Murat Gurses, Abdullah Tuncez, Huseyin Tezcan, Yasin Özen, Halil Ozalp, Tugay Dedebali, Mustafa Abdullah Kebude, Muhammet Salih Ates, Bulent Behlul Altunkeser","doi":"10.1080/10641963.2026.2627333","DOIUrl":"10.1080/10641963.2026.2627333","url":null,"abstract":"<p><strong>Background: </strong>Abnormal circadian blood pressure variation, particularly a non-dipper pattern, is associated with increased cardiovascular risk. Naples Prognostic Score (NPS) is a laboratory-based score that reflects the immune-inflammatory and nutritional status. Nevertheless, data regarding the relationship between NPS, circadian blood pressure patterns, and arterial stiffness in patients with newly diagnosed hypertension are limited. This study aimed to evaluate the relationship between blood pressure dipping status, the NPS, and arterial stiffness assessed by pulse wave velocity (PWV).</p><p><strong>Methods: </strong>This retrospective study included 297 newly diagnosed, untreated hypertensive patients who underwent 24-hour ambulatory blood pressure monitoring. Patients were classified as dipper (<i>n</i> = 145) or non-dipper (<i>n</i> = 152) according to nocturnal blood pressure decline. Laboratory parameters were recorded, NPS was calculated, and PWV was measured using a validated oscillometric device. Multivariate logistic regression analysis was performed to identify factors independently associated with non-dipper hypertension.</p><p><strong>Results: </strong>Non-dipper patients had significantly higher median NPS values compared with dippers [2 (0-4) vs. 1 (0-4), <i>p </i>< 0.001] and a higher prevalence of high NPS (score 3-4: 42.8% vs. 13.8%, <i>p </i>< 0.001). Median PWV was also significantly higher in the non-dipper group [7.70m/s (4.70-12.90) vs. 7.00m/s (4.40-11.20), <i>p</i> = 0.005]. After adjustment for clinically relevant covariates, both NPS (OR 1.71, 95% CI 1.19-2.47; <i>p</i> = 0.004) and PWV (OR 1.37, 95% CI 1.12-1.68; <i>p</i> = 0.002) were independently associated with non-dipper hypertension.</p><p><strong>Conclusion: </strong>In patients with newly diagnosed hypertension, a non-dipper blood pressure pattern is independently associated with higher systemic inflammatory burden and increased arterial stiffness. The NPS may serve as a simple and clinically applicable marker for early cardiovascular risk stratification in this population.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2627333"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131406","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":"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":"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":6.8,"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":"Associations of antihypertensive medication class with liver fibrosis and mortality in US adults with MASLD.","authors":"Yu Wu, Fei Fang","doi":"10.1080/10641963.2026.2725928","DOIUrl":"https://doi.org/10.1080/10641963.2026.2725928","url":null,"abstract":"<p><strong>Objective: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) frequently coexists with hypertension, yet comparative data on antihypertensive medication classes remain limited. We examined associations between antihypertensive medication class and liver fibrosis and mortality in US adults with MASLD.</p><p><strong>Methods: </strong>We conducted a prevalent-user analysis using National Health and Nutrition Examination Survey (NHANES) 1999-2018 data linked to mortality through 2019. Antihypertensive exposure was defined at baseline based on self-reported medication use, consistent with a prevalent-user design. Steatosis was defined by the US Fatty Liver Index (US-FLI). Fibrosis was assessed using FIB-4 and APRI within a model-based framework derived from vibration-controlled transient elastography. Analyses comparing antihypertensive classes were restricted to monotherapy users. Logistic regression and Cox models with inverse probability of treatment weighting and survey weights were applied.</p><p><strong>Results: </strong>Among participants with MASLD receiving antihypertensive monotherapy (<i>n</i> = 458; 86 deaths), ACEIs and ARBs were associated with lower all-cause mortality compared with calcium channel blockers (CCBs, reference group; <i>n</i> = 47; 15 deaths) (ACEIs: adjusted hazard ratio [aHR], 0.30; 95% CI, 0.11-0.82; ARBs: 0.25; 95% CI, 0.07-0.94). In cross-sectional analyses, antihypertensive medication use was associated with lower odds of liver fibrosis defined by FIB-4 and APRI within US-FLI-defined populations (MASLD: FIB-4 aOR 0.51 [0.29-0.91]; APRI aOR 0.49 [0.28-0.89]). Findings were broadly consistent across sensitivity analyses, including alternative model specifications and expanded covariate adjustment.</p><p><strong>Conclusions: </strong>Antihypertensive medication use, particularly ACEIs and ARBs, was associated with lower fibrosis prevalence and all-cause mortality in MASLD. These findings are hypothesis-generating and require confirmation in prospective studies.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2725928"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900156","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":"Electroacupuncture for essential hypertension: Mechanistic insights, current clinical evidence, and translational challenges.","authors":"Yanfang Zhou, Simin Qin, Yihong Ma","doi":"10.1080/10641963.2026.2685125","DOIUrl":"https://doi.org/10.1080/10641963.2026.2685125","url":null,"abstract":"<p><strong>Background: </strong>Essential hypertension (EH) remains a leading modifiable risk factor for cardiovascular morbidity and mortality worldwide. Electroacupuncture (EA), combining traditional acupuncture with pulsed electrical stimulation at specific acupoints, has attracted growing attention as a potential adjunctive strategy.</p><p><strong>Methods: </strong>A structured narrative literature search was conducted across PubMed, Web of Science, and CNKI databases up to January 2026. Search terms combined electroacupuncture-related terms with hypertension-, mechanism-, clinical trial-, and neuroimaging-related terms. Eligible studies included preclinical hypertension models, selected mechanistic studies from related cardiovascular models, completed clinical studies, published clinical trial protocols, and neuroimaging investigations relevant to EA and blood pressure regulation. Evidence sources were categorized as direct EH-specific evidence, indirect mechanistic evidence, adjunctive clinical evidence, or protocol-based evidence. No formal systematic review methodology was applied; this review should be interpreted as an integrative narrative synthesis.</p><p><strong>Results: </strong>Current evidence suggests that EA may influence blood pressure regulation through multiple preclinically supported mechanisms, including modulation of central sympathetic outflow, autonomic rebalancing, anti-inflammatory signaling, endothelial protection, and attenuation of myocardial remodeling. However, direct human evidence for EA in EH remains sparse. The current clinical literature consists mainly of one stage 1 hypertension study, adjunctive-therapy evidence, and published protocols with pending results, rather than completed, definitive EA-specific randomized trials that establish clinical efficacy.</p><p><strong>Conclusion: </strong>EA remains a biologically plausible but clinically unconfirmed adjunctive approach for EH. Its clinical efficacy, optimal parameters, and target populations require confirmation in completed, adequately powered, sham-controlled multicenter randomized trials.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2685125"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257605","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}