Clinical Hypertension最新文献

{"title":"Metabolic health and cardiovascular outcomes in treated hypertension: a secondary analysis of SPRINT.","authors":"Patrick Cheon, Uttsav Sandesara, Saeid Mirzai, Elsayed Z Soliman, Michael D Shapiro, Richard Kazibwe","doi":"10.5646/ch.2026.32.e33","DOIUrl":"10.5646/ch.2026.32.e33","url":null,"abstract":"<p><strong>Background: </strong>Metabolic abnormalities frequently coexist with hypertension and independently contribute to cardiovascular disease (CVD) risk. Whether metabolic dysfunction predicts incident CVD events and/or modifies the efficacy of intensive blood pressure control in primary prevention remains uncertain.</p><p><strong>Methods: </strong>Data from Systolic Blood Pressure Intervention Trial participants without baseline CVD or diabetes were analyzed. Metabolic health was classified based on triglycerides ≥ 150 mg/dL, high-density lipoprotein cholesterol < 40 mg/dL in men or < 50 mg/dL in women, fasting glucose ≥ 100 mg/dL, and body mass index ≥ 30 kg/m². Participants with ≤ 1 abnormality were classified as metabolically healthy (MH) and those with ≥ 2 as metabolically unhealthy (MUH). Cox proportional hazards models assessed the association of metabolic health status with outcomes and tested for effect modification by treatment arm. The primary outcome was a composite of myocardial infarction, acute coronary syndrome, stroke, heart failure, and cardiovascular death.</p><p><strong>Results: </strong>A total of 7,299 participants (mean age, 67.5 years; 37.9% female) were included, of whom 2,852 (39.1%) were classified as MUH. Over a median follow-up of 3.2 years, 440 primary outcome events occurred. The incidence of primary outcome events was higher in the MUH compared with the MH group (6.4% vs. 5.8%). After multivariable adjustment, MUH participants had a significantly higher risk of the primary outcome compared with MH participants (hazard ratio, 1.27; 95% confidence interval, 1.03-1.57; <i>P</i> = 0.024).</p><p><strong>Conclusions: </strong>Among hypertensive adults free of diabetes and CVD, MUH status was associated with higher cardiovascular risk; however, intensive systolic blood pressure lowering was protective across levels of metabolic burden.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e33"},"PeriodicalIF":6.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and preliminary effectiveness of mindfulness-based stress reduction program on patients with nocturnal hypertension: a pilot randomized controlled trial.","authors":"Shuqi Wang, Sze Nok Ng, Regina Wing Shan Sit, Chapman Cheuk Tung Ying, Shuk Yun Leung, Jinghao Han, Yue Kwan Choi, Kam Fai Chow, Wai Ho Chung, Benjamin Hon Kei Yip, Richard J McManus, Samuel Yeung Shan Wong, Eric Kam Pui Lee","doi":"10.5646/ch.2026.32.e34","DOIUrl":"10.5646/ch.2026.32.e34","url":null,"abstract":"<p><strong>Background: </strong>Nocturnal blood pressure (BP) during sleep is a stronger predictor of cardiovascular events than daytime BP. This pilot randomized controlled trial (RCT) aimed to assess feasibility and preliminary effectiveness of mindfulness-based stress reduction (MBSR) in managing nocturnal hypertension.</p><p><strong>Methods: </strong>Eligible patients were randomized to either a generic MBSR program or usual care (1:1). Primary outcomes included recruitment rate, dropout rate, adherence to ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM), and MBSR participation. Secondary outcomes encompassed BP measurements from ABPM, mood symptoms, sleep quality, mindfulness levels, and safety at 8 weeks, with acceptability evaluated through interviews.</p><p><strong>Results: </strong>All eligible patients were recruited (76/113), with 13 participants recruited monthly and a retention rate of 100%. The 83.3% of MBSR participants attended at least six classes, and they engaged in home practices on 77% of days during the 8-week program. All participants completed ABPM at baseline and 8 weeks; however, only 55.3% reported adequate nocturnal HBPM readings. While MBSR significantly reduced nocturnal systolic BP (121.9 vs. 128.6 mmHg, <i>P</i> < 0.001), no significant differences were observed on other outcomes and no adverse events were detected. Patients noted benefits from the MBSR course, although HBPM and ABPM disrupted sleep for a minority.</p><p><strong>Conclusion: </strong>This is the first RCT to investigate the effect of mindfulness on nocturnal BP in a Chinese population. We confirm the feasibility of a definitive RCT regarding patient recruitment and retention, acceptability of the intervention (i.e., MBSR), and data collection (e.g., repeated ABPM). Although MBSR may reduce nocturnal systolic BP by 7 mmHg, this needs to be confirmed in a definitive RCT.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06510907.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e34"},"PeriodicalIF":6.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baxdrostat as a catalyst for precision hypertension: integrating pharmacogenomics, omics biomarkers, and digital phenotyping in resistant hypertension management.","authors":"Asra Amjad, Syeda Tayyaba Batool, Umair Ali","doi":"10.5646/ch.2026.32.e27","DOIUrl":"10.5646/ch.2026.32.e27","url":null,"abstract":"","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e27"},"PeriodicalIF":6.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From concept to clinical practice: the evolution of low- and ultra-low-dose triple combination therapy for hypertension.","authors":"Jong Seon Park, Ki-Chul Sung, Moo-Yong Rhee","doi":"10.5646/ch.2026.32.e28","DOIUrl":"10.5646/ch.2026.32.e28","url":null,"abstract":"<p><p>Hypertension remains a leading contributor to global cardiovascular (CV) morbidity and mortality, yet blood pressure (BP) control rates remain suboptimal worldwide. Therapeutic inertia, delayed treatment intensification, dose-dependent adverse effects, and limited healthcare access continue to hinder effective management. Low-dose combination therapy has emerged as a strategy to enhance efficacy while improving tolerability by targeting complementary pathophysiological pathways at reduced drug doses. This review describes the evolution of low- and ultra-low-dose combination therapy from its pharmacologic rationale and early proof-of-concept studies to contemporary randomized and pragmatic trials. Meta-analytic and clinical evidence have demonstrated that combining antihypertensive agents at fractional doses produces additive BP reductions with fewer dose-related adverse effects. Subsequent trials evaluating quarter-dose and one-third-dose multidrug regimens confirmed substantial BP lowering with favorable safety profiles. Pragmatic studies further supported the feasibility of simplified, protocol-based single-pill strategies in real-world and resource-limited settings. More recent phase III trials have shown that single-pill low- and ultra-low-dose triple combinations achieve BP reductions comparable to or greater than those of standard-dose monotherapy, without compromising safety. Current evidences support low- and ultra-low-dose single-pill combination therapy as a practical and scalable first-line approach to improving global hypertension control. However, the current evidence base is dominated by trials evaluating short-term BP lowering rather than long-term CV outcomes. Although the magnitude and consistency of BP reduction provide a strong rationale for this strategy, evidence for reductions in CV events and mortality is warranted.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e28"},"PeriodicalIF":6.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal denervation revisited: is patient selection the missing link between failure and success?","authors":"Ehsan Shahverdi, Lars Roman Herda, Rojen Manouchehri, Sendooran Shahi, Mathias Lange","doi":"10.5646/ch.2026.32.e20","DOIUrl":"10.5646/ch.2026.32.e20","url":null,"abstract":"<p><p>Renal denervation (RDN) has re-emerged as a therapeutic option for hypertension following contemporary sham-controlled randomized trials demonstrating modest but consistent blood pressure (BP) reductions. Despite these advances, substantial heterogeneity in treatment response persists, sustaining debate regarding the clinical value and appropriate role of RDN. Increasing evidence suggests that patient-related factors, rather than device technology alone, may critically determine therapeutic success. This narrative review synthesizes evidence from randomized clinical trials, meta-analyses, and key observational studies published between 2009 and 2024. Relevant literature was identified through searches of PubMed, Embase, and major cardiovascular society publications. We evaluated the influence of hypertension phenotype, baseline BP, medication adherence, sympathetic nervous system activity, renal artery anatomy, and comorbid conditions on BP response to RDN. Accumulating data indicate that response to RDN is highly variable and strongly influenced by patient-specific characteristics. Sustained hypertension confirmed by ambulatory BP monitoring, higher baseline BP, features suggestive of sympathetic overactivity, favorable renal artery anatomy, and challenges with long-term medication adherence are consistently associated with greater BP reduction. In contrast, pseudoresistance, white-coat hypertension, advanced arterial stiffness, and unfavorable anatomy are linked to attenuated or inconsistent responses. Reassessment of sham-controlled trials highlights that observed BP reductions, although modest, are clinically meaningful when appropriately contextualized. The efficacy of RDN is highly context-dependent and should not be viewed as universal or ineffective. By shifting from a device-centered paradigm to mechanism-based patient phenotyping, RDN may be more accurately positioned as a targeted, adjunctive therapy within personalized hypertension management. A structured framework for patient selection may help reconcile prior controversies, optimize clinical implementation, and inform the design of future trials.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e20"},"PeriodicalIF":6.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Famine and blood pressure trajectories across 2 generations: a prospective cohort study.","authors":"Fanfan Chan","doi":"10.5646/ch.2026.32.e25","DOIUrl":"10.5646/ch.2026.32.e25","url":null,"abstract":"<p><strong>Background: </strong>While the transgenerational impact of famine on adult health is well-documented, its impact on blood pressure (BP) trajectories from childhood to adolescence remains poorly understood. We aimed to capture multi-generational BP trajectories and identify the primary drivers of adolescent BP elevation.</p><p><strong>Methods: </strong>Utilizing data from the China Health and Nutrition Survey, we analyzed BP trajectories in the F1 (<i>n</i> = 5,357) and F2 (<i>n</i> = 2,349) generations. The F1 generation was categorized into 2 groups: famine exposed and non-exposed groups, while the F2 generation was divided into 4 groups: no parental exposure, father-only-exposed, mother-only-exposed, and both-parents-exposed. Linear mixed-effects models and causal mediation analyses were conducted to ascertain BP trajectories and the mediation of parental body mass index (BMI).</p><p><strong>Results: </strong>In the F1 generation, BP of famine-exposed individuals surpassed that of controls after age 40. In the F2 generation, BP trajectory divergence occurred at approximately age 14. By age 18, all exposed groups had significantly higher BP than controls, independent of parental hypertension (<i>P</i> < 0.01). Notably, the mother-only-exposed group exhibited the highest velocity of BP elevation; however, after excluding offspring with hypertensive parents, the father-only-exposed group exhibited the fastest velocity of BP increase. Mediation analysis revealed that over 85% of this effect was direct, with parental BMI accounting for only 14.51% and 10.08% of the effect for systolic and diastolic BP, respectively.</p><p><strong>Conclusions: </strong>Individuals with direct famine exposure possess higher rate of BP elevation. Furthermore, parental famine exposure programs an accelerated BP velocity in offspring that manifests during early adolescence. These findings suggest that the famine exposure creates a subclinical vascular risk that requires early monitoring, independent of adiposity and hypertension.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e25"},"PeriodicalIF":6.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global trends and geographic variations of hypertension in childhood and adolescence 1990-2021: a systematic analysis of the Global Burden of Disease Study 2021.","authors":"Yu Hyeon Chu, Jueon Kim, Sarah Soyeon Oh, Jong Hoon Han, Min Seo Kim, Dong Keon Yon, Jae Il Shin, Joseph T Flynn","doi":"10.5646/ch.2026.32.e30","DOIUrl":"10.5646/ch.2026.32.e30","url":null,"abstract":"<p><strong>Background: </strong>Childhood hypertension is strongly associated with the development of cardiovascular diseases in adulthood. Understanding the epidemiological patterns of disease burden is crucial for developing effective prevention strategies.</p><p><strong>Methods: </strong>This cross-sectional study utilized data from the Global Burden of Disease Study (GBD) 2021, including 204 countries and territories. The analysis estimated deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) attributable to high systolic blood pressure (sBP) among individuals under the age of 20 within the GBD comparative risk assessment (CRA) framework, covering the period from 1990 to 2021. Trends and regional disparities in disease burden were examined, emphasizing correlations between DALY rates and socio-demographic indices (SDI).</p><p><strong>Results: </strong>In 2021, the global DALY rate was 2.39 (95% uncertainty interval [UI], 1.75 to 2.88) per 100,000 population, representing a 20.11% decrease (95% UI, -35.02 to 10.21) compared to 1990. The YLL rate showed a decrease of 21.06% (95% UI, -36.21 to 9.95), contributing to the decline in the DALY rate, whereas the YLD rate showed an increase of 22.33% (95% UI, 4.16 to 40.74). The DALY rates were negatively correlated with Socio-demographic Index. Among the 21 GBD regions in 2021, Middle East and North Africa (MENA) showed the highest disease burden across all metrics. Western Sub-Saharan Africa (SSA) demonstrated a pronounced gender disparity. High-income North America experienced the largest increase in disease burden.</p><p><strong>Conclusions: </strong>Global DALYs and deaths attributable to high sBP among children and adolescents suggested a declining trend from 1990 to 2021, although the 95% UIs were compatible with no clear change. DALYs showed a negative correlation with SDI, with highest burden in MENA and notable gender disparities in Western SSA. High-income North America showed the largest increase since 1990.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e30"},"PeriodicalIF":6.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart rate and left ventricular remodeling after repaired coarctation of the aorta: a cross-sectional study.","authors":"Marina Vaccari, Laura E Maldonado, Claudio G Moros, Angela Sardella, Miriam Romo, César A Romero","doi":"10.5646/ch.2026.32.e29","DOIUrl":"10.5646/ch.2026.32.e29","url":null,"abstract":"<p><strong>Background: </strong>Patients with repaired coarctation of the aorta (CoAo) remain at risk for left ventricular hypertrophy (LVH) even in the absence of hypertension. Alterations in wave reflection and the timing of reflected pressure waves may contribute to ventricular remodeling beyond pressure load alone.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of patients with repaired CoAo. Office and ambulatory blood pressure (ABPM), non-invasive central hemodynamics, and echocardiographic indices of left ventricular structure were assessed. Linear and multivariable regression models evaluated associations with posterior wall thickness in diastole (PWTd) and interventricular septal thickness in diastole. Computational simulations were conducted to examine the impact of heart rate on ventricular remodeling.</p><p><strong>Results: </strong>Fifty-seven patients (median post-repair follow-up 11 years) were included. LVH prevalence was 15.2% (95% confidence interval [CI], 4.8, 25.6). Although 42% met criteria for hypertension based on ABPM, no patients exhibited elevated central blood pressure and LVH. Heart rate-adjusted augmentation index (AIX@75) was inversely associated with PWTd and remained independently associated after multivariable adjustment (R² = 0.40, <i>P</i> < 0.01). Replacing AIX@75 by heart rate improved model performance (R² = 0.44), with lower heart rate independently associated with greater PWTd. Simulation modeling showed that a 10% increase in heart rate reduced mean PWTd and decreased posterior wall hypertrophy prevalence from 30.9% to 2.4% (odds ratio, 0.10; 95% CI, 0.01, 0.44).</p><p><strong>Conclusions: </strong>Ventricular remodeling occurs despite normal central blood pressure in CoAo. A lower heart rate associates with increased ventricular mass. Heart rate-mediated modulation of wave reflection timing represents a potential mechanistic and therapeutic target.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e29"},"PeriodicalIF":6.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights of the 2026 Korean Society of Hypertension guidelines for the management of hypertension: what's new and what has changed.","authors":"Eun Mi Lee, In-Jeong Cho, Hee-Taik Kang, Kwang-Il Kim, Dae-Hee Kim, Ju Han Kim, Hack-Lyoung Kim, Hyeon Chang Kim, Hae Jin Kim, Eun Sil Koh, Sungha Park, Jong-Moo Park, Jeong-Hun Shin, Janghoon Lee, Hae Young Lee, Hokyou Lee, Mi-Hyang Jung, Eun Joo Cho, Seonghoon Choi, Sang-Hyun Ihm","doi":"10.5646/ch.2026.32.e31","DOIUrl":"10.5646/ch.2026.32.e31","url":null,"abstract":"<p><p>The recently released 2026 Korean Society of Hypertension (KSH) guidelines incorporate contemporary advances in the diagnosis and management of hypertension. This highlight summarizes the most important updates, focusing on the underlying evidence and key changes, particularly the newly introduced and revised recommendations. The major additions include the incorporation of isolated diastolic hypertension into blood pressure (BP) classification, the first integration of cuffless BP devices into clinical practice, and the incorporation of a new therapy with a BP-lowering effect (angiotensin receptor-neprilysin inhibitors, sodium-glucose cotransporter 2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, and aldosterone synthase inhibitors). A dose-based classification of single-pill combination therapies has been introduced to enhance treatment adherence. In addition, obesity, hypertension in young adults, hypertensive emergencies, and patient-centered care have been incorporated and emphasized. Major updates include expanded screening for primary aldosteronism, adoption of more intensive BP targets, and risk-based initiation of pharmacological therapy in individuals with prehypertension. Lifestyle recommendations have been broadened to include e-smoking cessation and mind-body practices. Furthermore, the definition and management of uncontrolled (or resistant) hypertension have been updated, and BP targets in older adults are now individualized according to frailty status and overall cardiovascular risk; intensive BP lowering to 130/80 mmHg is recommended in selected high-risk older individuals. Finally, BP management during pregnancy has also been refined to emphasize active BP control at < 140/90 mmHg and the use of out-of-office BP measurements for more accurate diagnosis. Overall, the new KSH guidelines provide a more evidence-based framework for hypertension management, with the goal of improving BP control and reducing cardiovascular morbidity and mortality.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e31"},"PeriodicalIF":6.2,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between hypertension care cascade, cognitive function, and cardiovascular disease in middle-aged and older adults: the exacerbated role of social isolation.","authors":"Chang Xiong, Weida Qiu, Kehao Zeng, Muhan Tang, Zhiping Gao, Liwen Li","doi":"10.5646/ch.2026.32.e23","DOIUrl":"10.5646/ch.2026.32.e23","url":null,"abstract":"<p><strong>Background: </strong>The role of social isolation in the connections between the hypertension care cascade, cognitive function, and cardiovascular disease (CVD) remains unclear. This study aims to investigate the relationships between the hypertension care cascade, cognitive performance, and CVD among middle-aged and older adults with varying levels of social isolation.</p><p><strong>Methods: </strong>Eight thousand two hundred eighty-seven participants aged 45 years and older from the China Health and Retirement Longitudinal Study were included in the analysis. Participants were categorized based on their social isolation status, either as socially isolated or not. Both multivariable linear regression and logistic regression models were employed. All analyses were weighted to account for the multistage, probability-proportional-to-size sampling design of the study. Hypertension was defined according to European, Chinese, and American guidelines.</p><p><strong>Results: </strong>The weighted rates of hypertension awareness, treatment, and control were 55.0%, 44.5%, and 25.4%, respectively, with a more favorable performance in the hypertension care cascade observed among individuals without social isolation. When applying American guidelines to define hypertension, the rates of awareness, treatment, and control significantly declined, irrespective of social isolation status. Compared to non-hypertensive individuals, participants with treated and controlled blood pressure (BP) exhibited similar cognitive function and odds of CVD. In contrast, individuals with treated but uncontrolled BP and those who were unaware of hypertension demonstrated poorer cognitive performance and a heightened risk of CVD. Social isolation significantly exacerbated the negative effects of poor hypertension care cascade on cognitive function and CVD risk. Isolated individuals who are unaware of hypertension faced a more higher risk of worsen prognosis than that of the non-isolated individuals (<i>P</i> for interaction < 0.05).</p><p><strong>Conclusions: </strong>Individuals experiencing social isolation exhibited poor performance in the hypertension care cascade. Furthermore, social isolation significantly exacerbated the negative effects of poor hypertension care cascade on cognitive function and CVD. Our study emphasizes that addressing social isolation could be a significant factor for improving the hypertension care cascade and health outcomes among middle-aged and older adults in China.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e23"},"PeriodicalIF":6.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}