Clinical and Experimental Hypertension最新文献

{"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":"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":6.8,"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":"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":"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":6.8,"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":"Association of intracranial atherosclerotic stenosis with 1-year cognitive impairment after acute ischemic stroke or transient ischemic attack: a nationwide prospective cohort study.","authors":"Yanyan Cao, Ganghua Feng, Yu Zhang, Zi Ye, Aoming Jin, Yang Xu, Yunhui Li, Jing Jing, Jie Xu, Shoucai Zhao","doi":"10.1080/10641963.2026.2671040","DOIUrl":"https://doi.org/10.1080/10641963.2026.2671040","url":null,"abstract":"<p><strong>Background and purpose: </strong>Intracranial atherosclerotic stenosis (ICAS) is common in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA), but its relationship with long-term cognitive impairment remains unclear. This study examined whether ICAS was associated with 1-year cognitive impairment after AIS/TIA independently of cerebral small vessel disease (CSVD) and extracranial carotid artery stenosis (ECAS).</p><p><strong>Methods: </strong>Data were obtained from the impairment of cognition and sleep after AIS or TIA in Chinese patients (ICONS), a subgroup of the China National Stroke Registry III. Patients with AIS or TIA within 7 days of onset who had baseline vascular imaging and 12-month cognitive assessment were included. ICAS was defined as intracranial arterial stenosis ≥50%. The primary outcome was cognitive impairment at 12 months, defined as a Montreal Cognitive Assessment (MoCA) score <23. Multivariable logistic regression and domain-specific linear regression analyses were performed after adjustment for demographic characteristics, vascular risk factors, CSVD markers, ECAS, stroke severity, and baseline cognitive status.</p><p><strong>Results: </strong>A total of 1261 patients were included. Patients with ICAS had a significantly higher rate of cognitive impairment at 1 year than those without ICAS. After full adjustment, ICAS remained independently associated with 1-year cognitive impairment (odds ratio 1.524, 95% confidence interval 1.068-2.176; <i>p</i> = 0.020). ICAS was also significantly associated with poorer recall performance (<i>β</i> = -0.182, 95% confidence interval -0.293 to -0.071; <i>p</i> = 0.001), but not with other cognitive domains.</p><p><strong>Conclusions: </strong>ICAS was independently associated with an increased risk of 1-year cognitive impairment after AIS/TIA, particularly in memory performance.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2671040"},"PeriodicalIF":3.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257576","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":"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":6.8,"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":"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":6.8,"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":"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":6.8,"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":"Early prediction of preeclampsia among the advanced-age pregnant women: A retrospective multicenter study.","authors":"Andong He, Xiaojun Li, Ka Cheuk Yip, Xiaolin Wu, Shuyun He, Laru Peng, Ling Li, Jun Kong, Jinju Yang, Ruiling Yan, Wei Li, Ruiman Li","doi":"10.1080/10641963.2026.2713198","DOIUrl":"10.1080/10641963.2026.2713198","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity. Women of advanced maternal age (AMA, ≥ 35 years) constitute a rapidly expanding high-risk subpopulation in China. Existing first-trimester prediction models were derived in general obstetric populations and often rely on specialized biophysical or proprietary biomarker assays, with limited validation in AMA women.</p><p><strong>Methods: </strong>This multicenter retrospective study enrolled 2,582 AMA pregnant women from three tertiary centers in southern China, partitioned into a training cohort (<i>n</i> = 1,327), an internal validation cohort (<i>n</i> = 569), and two external validation cohorts (<i>n</i> = 399 and 287). Predictors were selected using LASSO and multivariable logistic regression and assembled into a nomogram. Performance was evaluated by area under the receiver operating characteristic curve (AUC), calibration, Brier scores, decision curve analysis, and clinical impact curves.</p><p><strong>Results: </strong>Seven independent predictors were retained: pre-pregnancy BMI, parity, mode of conception, uric acid, white blood cell count, red blood cell count, and hemoglobin. The nomogram achieved AUCs of 0.819, 0.795, 0.787, and 0.756 across the four cohorts, with close calibration and favorable net benefit. Performance was preserved when women with chronic hypertension were included and across early-onset and late-onset PE subgroups. Notably, maternal age itself was not discriminative within the AMA stratum (<i>P</i> = 0.626).</p><p><strong>Conclusions: </strong>This nomogram relying exclusively on routine clinical and laboratory parameters provides an accessible tool for individualized early-pregnancy PE risk assessment and risk-stratified antenatal management in AMA women.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2713198"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663551","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":"Extracellular vesicles from the rostral ventrolateral medulla microenvironment regulate stress-induced hypertension via TNF-α-mediated modulation of neuronal excitability.","authors":"Haisheng Liu, Xiaole Chang, Linping Wang, Wen Lu, Chen Yu, Dongshu Du, Wei Guo","doi":"10.1080/10641963.2026.2726549","DOIUrl":"https://doi.org/10.1080/10641963.2026.2726549","url":null,"abstract":"<p><strong>Objective: </strong>Stress-induced hypertension (SIH) is driven by sympathetic overactivity, with the rostral ventrolateral medulla (RVLM) serving as a key regulatory hub. Extracellular vesicles (EVs) mediate intercellular communication, but their role in RVLM-related SIH pathogenesis remains unclear.</p><p><strong>Methods: </strong>A rat SIH model was established via 15 days of unpredictable stress. The EV secretion inhibitor GW4869 was microinjected into the RVLM of SIH rats to observe alterations in blood pressure and neuronal excitability. RVLM-EVs were isolated using iodixanol density gradient centrifugation and used to treat primary RVLM neurons in vitro; neuronal excitability was evaluated by c-FOS immunofluorescence staining. Bead-based flow cytometry was performed to detect the protein components of RVLM-EVs, and the TNF-<i>α</i> antagonist R7050 was administered for both in vitro and in vivo interventions to examine its regulatory effects on neuronal excitability and blood pressure.</p><p><strong>Results: </strong>GW4869 reduced BP and neuronal excitability in SIH rats. SIH-RVLM-EVs, with larger particle size, were internalized by primary RVLM neurons, enhancing excitability and inducing hypertension in normotensive rats. TNF-<i>α</i> was enriched in SIH-RVLM-EVs; R7050 abrogated these pro-hypertensive effects in vitro and in vivo.</p><p><strong>Conclusion: </strong>RVLM-derived EVs promote SIH by delivering TNF-<i>α</i>, which enhances RVLM pre-sympathetic neuronal excitability and sympathetic overactivity. TNF-<i>α</i> in RVLM-EVs is a promising therapeutic target for SIH.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2726549"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886569","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":"Efficacy and mechanistic insights of dapagliflozin in hypertension management.","authors":"Zhongbo Chen, Wang Chunbin, Hanmei Zhang, Ting Luo, Jinhua Yan","doi":"10.1080/10641963.2026.2731624","DOIUrl":"https://doi.org/10.1080/10641963.2026.2731624","url":null,"abstract":"<p><p>Hypertension remains one of the leading modifiable risk factors for cardiovascular disease and premature mortality worldwide. Blood pressure (BP) management is particularly challenging in patients with coexisting type 2 diabetes (T2D), chronic kidney disease (CKD), or heart failure (HF). Sodium-glucose cotransporter 2 (SGLT2) inhibitors have become an integral component of contemporary cardiorenal therapy and have consistently demonstrated additional BP-lowering effects across diverse clinical settings. This narrative review synthesizes the current clinical evidence regarding the antihypertensive effects of dapagliflozin and summarizes the biological mechanisms that may contribute to these effects, including osmotic diuresis and natriuresis, weight reduction, modulation of the sympathetic nervous system, enhanced uric acid excretion, and attenuation of oxidative stress, inflammation, and vascular dysfunction. Across clinical studies, reductions in systolic BP (SBP) generally exceed those in diastolic BP (DBP), although the physiological basis underlying this differential response remains incompletely understood. Dapagliflozin has demonstrated good tolerability and antihypertensive effects in clinical applications, its long-term use may be limited by the risk of genital infections. Collectively, the available evidence supports dapagliflozin as a cardiorenal therapeutic agent that may provide additional BP-lowering benefits in patients with hypertension and concomitant T2D, CKD, or HF, rather than as a substitute for conventional antihypertensive therapy. Future hypertension-focused clinical studies are warranted to further define its role in hypertension management.</p>","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2731624"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104969","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}