Clinical Hypertension最新文献

{"title":"Cardiac magnetic resonance assessment of left ventricular phenotypes and prognostic implications in hypertensive heart disease.","authors":"Piyawat Lertsiripatarajit, Kasinee Wanitchung, Sumet Prechawuttidech, Sasima Tongsai, Yodying Kaolawanich","doi":"10.5646/ch.2026.32.e14","DOIUrl":"10.5646/ch.2026.32.e14","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated an association between left ventricular (LV) phenotypes assessed by echocardiography and clinical outcomes in patients with hypertensive heart disease (HHD). However, data evaluating LV phenotypes using cardiac magnetic resonance (CMR)-the reference standard for quantification of LV volume, mass, and function-remain limited. This study aimed to assess the prognostic value of CMR-derived LV phenotypes in patients with HHD.</p><p><strong>Methods: </strong>We included 756 consecutive patients with hypertension who were referred for clinically indicated CMR at an academic hospital in Thailand between 2011 and 2019. Four LV phenotypes were defined using LV mass index (LVMI), LV mass-to-volume ratio, and LV end-diastolic volume index (LVEDVI). Patients were followed for major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, hospitalization for heart failure, and stroke.</p><p><strong>Results: </strong>The mean age was 70 ± 10 years, and 47% of patients were male. At baseline, 42.3% had controlled blood pressure, 37.0% had grade 1 hypertension, and 20.7% had grade 2-3 hypertension. The mean LVEF was 70.9 ± 9.7%. Over a median follow-up of 7.1 years (interquartile range 4.1-9.2), 153 MACE occurred. Annualized MACE rates were highest in patients with eccentric hypertrophy (5.8 per 100 patient-years), followed by concentric hypertrophy (3.5), concentric remodeling (2.7), and normal geometry (1.5). After multivariable adjustment, concentric remodeling (adjusted hazard ratio [HR], 2.22; 95% confidence interval [CI], 1.30-3.81; <i>P</i> = 0.004), concentric hypertrophy (adjusted HR, 2.81; 95% CI, 1.77-4.46; <i>P</i> < 0.001), and eccentric hypertrophy (adjusted HR, 2.40; 95% CI, 1.40-4.14; <i>P</i> = 0.002) remained independently associated with MACE. In addition, the combined inclusion of LVEDVI and LVMI, as well as LV phenotypes, provided incremental prognostic value beyond the baseline model (incremental χ² = 23.29, <i>P</i> < 0.001 and 23.60, <i>P</i> < 0.001, respectively).</p><p><strong>Conclusions: </strong>CMR-based LV phenotyping was associated with prognosis in patients with HHD, with abnormal LV phenotypes demonstrating higher risks of MACE compared with normal geometry. These findings indicate that CMR may have a complementary role in risk assessment among patients with hypertension.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e14"},"PeriodicalIF":6.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638098","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":"24-Hour ambulatory blood pressure and C-reactive protein: a systematic review and meta-analysis.","authors":"Joanna Sulicka-Grodzicka, Karolina Piotrowicz, Marcin Cwynar, Mariusz Korkosz, Tomasz J Guzik, Pasquale Maffia, Jerzy Gąsowski","doi":"10.5646/ch.2026.32.e10","DOIUrl":"10.5646/ch.2026.32.e10","url":null,"abstract":"<p><strong>Background: </strong>Inflammation plays a key role in pathophysiology of hypertension; however the relevance of specific inflammatory mediators, such as C-reactive protein (CRP) is uncertain. We conducted a systematic literature review and meta-analysis to assess the associations between CRP levels and 24-hour blood pressure (BP) values in adult patients.</p><p><strong>Methods: </strong>We performed a systematic search of PubMed/MEDLINE, Embase, Web of Science, and Scopus for human studies published between January 2013 and June 2023. We included cross-sectional and cohort studies. We excluded studies reporting clinically significant inflammation. We calculated the Pearson's correlation coefficients between 24-hour BP indices and the CRP levels weighted by the inverse of their variances.</p><p><strong>Results: </strong>Of 716 reports identified, 20 met eligibility criteria (10,799 participants, mean age ± standard deviation [SD] 56.1 ± 9.5 years, mean ± SD 24-hour systolic BP [SBP] 132.2 ± 14.3 mmHg, and diastolic BP [DBP] 79.3 ± 9.8 mmHg). CRP ranged from 0.14 to 10.6 mg/L, median 2.66 mg/L (interquartile range, 1.13-5.13 mg/L). In the subgroup of studies where CRP levels were ≥ 3 mg/L, a significant positive association between CRP and average 24-hour SBP (<i>r</i> = 0.79, <i>P</i> < 0.001) and DBP (<i>r</i> = 0.83, <i>P</i> < 0.001) was observed. When all studies were analyzed however, there was no correlation between CRP and neither 24-hour SBP (<i>r</i> = 0.18, <i>P</i> = 0.29), nor DBP (<i>r</i> = 0.27, <i>P</i> = 0.94).</p><p><strong>Conclusions: </strong>CRP may be an important biomarker of the relationship between inflammation and hypertension. However, the relation may not be linear throughout the entire range of CRP values.</p><p><strong>Trial registration: </strong>International Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD42023462606.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e10"},"PeriodicalIF":6.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376360","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 failure associated with renal artery stenosis and Pickering syndrome: the critical role of endovascular revascularization: a case series and meta-analysis.","authors":"Matteo Regolo, Lara Ponsa, Franco Rabbia, Lorenzo Malatino, Franco Veglio, Marco Pappaccogli","doi":"10.5646/ch.2026.32.e9","DOIUrl":"10.5646/ch.2026.32.e9","url":null,"abstract":"<p><strong>Background: </strong>Heart failure associated with renal artery stenosis (RAS) and Pickering syndrome, characterized by recurrent flash pulmonary oedema (FPE) in the setting of bilateral RAS or unilateral stenosis in a solitary kidney, represent 2 severe forms of renovascular disease. Despite their clinical significance, the role of endovascular treatment is still debated due to inconsistent findings from randomized trials.</p><p><strong>Methods: </strong>This study combines a case series of patients with Pickering syndrome undergoing percutaneous transluminal renal angioplasty (PTRA) with a meta-analysis evaluating the efficacy of endovascular treatment in patients with atherosclerotic RAS and heart failure. The meta-analysis included studies comparing endovascular intervention plus medical therapy against medical therapy alone.</p><p><strong>Results: </strong>In the case series, all patients experienced significant improvement in blood pressure (BP) control, reduction in pulmonary congestion, and stabilization of renal function following PTRA. The meta-analysis demonstrated a significant reduction in systolic BP (-11.73 mmHg, 95% confidence interval, -22.97, -0.48) in patients with heart failure undergoing PTRA, while no significant benefit was observed in those without heart failure.</p><p><strong>Conclusions: </strong>Our findings suggest that endovascular therapy is beneficial in selected patients with RAS, particularly in those with recurrent FPE or heart failure. Future research should refine patient selection criteria to improve outcomes and reconsider the role of revascularization in high-risk subgroups.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e9"},"PeriodicalIF":6.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375787","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":"Evaluation of guideline adherence to hypertension-mediated organ damage screening in Korean patients with hypertension: results from the Korean Registry of Target Organ Damage in Hypertension (KorHR).","authors":"Do Young Kim, Sung Hea Kim, Seong Woo Han, Jong Sun Ok, Jung-Woo Son, Jin-Ok Jeong, Eung Ju Kim, Seonghoon Choi, In Hyun Jung, Sung Kee Ryu, Mi-Seung Shin, Kyu-Hyung Ryu","doi":"10.5646/ch.2026.32.e11","DOIUrl":"10.5646/ch.2026.32.e11","url":null,"abstract":"<p><strong>Background: </strong>Adherence to guidelines for hypertension-mediated organ damage (HMOD) assessment has not been extensively studied. We aimed to evaluate guideline adherence to HMOD assessment and to identify factors associated with this adherence.</p><p><strong>Methods: </strong>In this prospective, multicenter observational study conducted from May 2013 to December 2022, we evaluated adherence to guideline-recommended HMOD screening among 2,070 hypertensive patients enrolled from 24 tertiary care centers in Korea. Patients were categorized as either newly treated or on treatment. The basic screening tests included urine albumin-to-creatinine ratio (UACR), electrocardiography (ECG), and glomerular filtration rate (GFR). The extended screening tests included echocardiography, carotid ultrasonography, fundoscopic examination, ankle-brachial index measurement, and brachial-ankle pulse wave velocity assessment.</p><p><strong>Results: </strong>The overall adherence rate for basic screening was 68.4%. Compliance with GFR and ECG assessments was high (90.3% and 95.2%, respectively), whereas adherence to UACR testing was lower (72.5%). The adherence rate for basic screening was significantly lower in the on-treatment group compared with the newly treated group (57.1% vs. 79.9%). Elderly patients (≥ 60 years) exhibited the lowest adherence to basic screening. Further analyses revealed that increasing age was significantly associated with a lower likelihood of completing both basic and extended screenings.</p><p><strong>Conclusions: </strong>Guideline-recommended HMOD screening remains underutilized in routine clinical practice, particularly among elderly patients. These findings underscore the need to improve adherence to HMOD screening.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT01861080.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e11"},"PeriodicalIF":6.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376338","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":"Association of resting heart rate trajectories with incident chronic kidney disease in patients with hypertension.","authors":"Zhen Ge, Jianxiang Huang, Chi Wang, Shuang Guo, Taoyu Hu, Lihua Lan, Shuohua Chen, Shouling Wu, Hao Xue","doi":"10.5646/ch.2026.32.e8","DOIUrl":"10.5646/ch.2026.32.e8","url":null,"abstract":"<p><strong>Background: </strong>An elevated resting heart rate (RHR) increases the risk of chronic kidney disease (CKD), but the relationship between longitudinal patterns of RHR and the risk of CKD in hypertensive patients is unclear. We aimed to explore the association between RHR trajectories and incident CKD in hypertensive patients.</p><p><strong>Methods: </strong>A total of 21,509 hypertensive participants from the Kailuan cohort who were free of CKD and cardiovascular disease before 2010 were included. The RHR trajectories were developed using latent mixture modeling based on examination data in 2006, 2008, and 2010. Cox proportional hazards regression models were established to evaluate the association between RHR trajectories and risk of incident CKD.</p><p><strong>Results: </strong>We identified 4 RHR trajectories in participants with hypertension between 2006 and 2010: low-stable group (<i>n</i> = 2,465 [11.46%], mean RHR range, 63.33-65.06 beats/min); moderate low-stable group (<i>n</i> = 15,610 [72.57%], mean RHR range, 73.09-74.32 beats/min); moderate high-stable group (<i>n</i> = 3,158 [14.68%], mean RHR range, 84.32-85.43 beats/min,) and elevated-stable group (<i>n</i> = 276 [1.28%], mean RHR range, 99.63-100.74 beats/min). During an average follow-up of 7.93 years, 2,769 cases of CKD were identified. Compared with the moderate low-stable group, adjusted hazard ratios for CKD were 1.15 (95% confidence interval [CI], 1.03-1.29) for the low-stable group, 1.22 (95% CI, 1.10-1.37) for the moderate high-stable group, and 1.54 (95% CI, 1.13-2.09) for the elevated-stable group.</p><p><strong>Conclusions: </strong>RHR trajectories were associated with the risks of CKD in patients with hypertension.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e8"},"PeriodicalIF":6.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376284","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":"Incidence and prognosis of apparent-treatment resistant hypertension: a multi-state analysis using real world evidence.","authors":"Htun Teza, Thunyarat Anothaisintawee, Thosaphol Limpijankit, Amarit Tansawet, Suparee Boonmanunt, Anuchate Pattanateepapon, Gareth J McKay, John Attia, Ammarin Thakkinstian","doi":"10.5646/ch.2026.32.e5","DOIUrl":"10.5646/ch.2026.32.e5","url":null,"abstract":"<p><strong>Background: </strong>There is limited evidence regarding the incidence and prognosis of apparent resistant hypertension (aRHT) in hypertensive patients. This study aimed to estimate the incidence of aRHT and assess the risk of cardiovascular and kidney complications in patients with aRHT compared to those without aRHT, using a multi-state analysis.</p><p><strong>Methods: </strong>This retrospective cohort study utilized real-world data from hypertensive patients treated at Ramathibodi Hospital, Bangkok, Thailand, between January 2010 and June 2024. aRHT was defined as having uncontrolled blood pressure (BP), while using ≥ 3 antihypertensive medications or having controlled BP with using ≥ 4 antihypertensive medications. The outcomes of interest were cardiovascular and kidney complications including coronary artery disease (CAD), stroke, heart failure (HF), and chronic kidney disease (CKD), and all-cause mortality. A multi-state analysis was applied to estimate the risk of disease progression from hypertension without complications to aRHT, CAD, stroke, HF, CKD, and all-cause death. Kaplan-Meier estimates with a clock-reset approach were used to calculate transition probabilities for each progression. Multivariate Cox regression analysis was applied to assess the risk factors of aRHT and assess the prognosis of aRHT.</p><p><strong>Results: </strong>Among 114,364 hypertensive patients, the incidence of aRHT was 2.61 per 100 person-years (95% confidence interval [CI], 2.56-2.65). Results from multivariate Cox regression analysis found that the independent risk factors of aRHT were increasing age, males, obesity, type 2 diabetes mellitus, dyslipidemia, and having cardiovascular and kidney complications including CAD, stroke, CKD, and HF. Regarding the prognosis of aRHT, compared to non-aRHT patients, those with aRHT had significant higher risk of CAD, CKD, HF, and all-cause mortality with hazard ratios (95% CI) of 1.80 (1.56-2.08), 1.93 (1.79-2.08), 4.24 (3.54-5.08), and 2.84 (1.89-4.27), respectively.</p><p><strong>Conclusions: </strong>The risk of aRHT was higher in hypertensive patients with cardiovascular and kidney complications compared to those without. Patients with aRHT had a worse prognosis than hypertensive patients without aRHT, as evidenced by higher risks of CAD, CKD, HF, and all-cause death.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e5"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141238","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":"A comparison of blood pressure reference values and the prevalence of high blood pressure in Indian adolescents aged 10-16 years using American and Indian reference standards.","authors":"Aswathi Saji, Tinku Thomas, Harshpal Singh Sachdev, Anura V Kurpad, Anil Vasudevan","doi":"10.5646/ch.2026.32.e7","DOIUrl":"10.5646/ch.2026.32.e7","url":null,"abstract":"<p><strong>Background: </strong>High blood pressure (BP) in children and adolescents is a major public health concern globally, including in India. It is typically defined by BP > 95th percentile of normative BP distribution, with the American Academy of Pediatrics Clinical Practice Guidelines (AAP-CPG 2017) being most widely used. However, Indian-specific reference derived from healthy children set higher BP cut-offs than AAP-CPG 2017, leading to debate about their suitability. This study compares high BP prevalence using both references and examines how each classification by the 2 reference standards relates to cardiometabolic risk factors.</p><p><strong>Methods: </strong>A secondary analysis of cross-sectional data from the Comprehensive National Nutrition Survey (2016-2018) was conducted to compare the prevalence of high BP in Indian adolescents aged 10-16 years using Indian and AAP-CPG 2017 references. The association between cardio-metabolic risk markers and high BP classified by these references was examined by survey weighted multiple log-binomial regression to examine the validity of each reference standard.</p><p><strong>Results: </strong>In young adolescents aged 10-12 years, the prevalence of high BP was 16% (95% confidence interval [CI], 13.6-19%) and 33.6% (95% CI, 30.4-37%) by Indian and AAP-CPG reference respectively. Similarly, in older adolescents aged 13-16 years, the prevalence of high BP was lower with Indian reference. The adjusted risk ratios (ARRs) for high triglycerides, total cholesterol, and low-density lipoprotein were significantly elevated in young adolescents with high BP by AAP-CPG 2017 reference but not with Indian reference.</p><p><strong>Conclusions: </strong>The prevalence of high BP among Indian adolescents differed significantly based on the BP reference standard used. Clustering of cardiometabolic risk markers with high BP was observed when using the AAP-CPG reference but not with Indian reference. However, these findings should be interpreted cautiously given the cross-sectional study design with single visit BP measurement and limited generalizability of the Indian BP reference standard. Larger, nationally representative studies using standardized BP measurement methods are essential to establish validated BP norms for Indian adolescents.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e7"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141275","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":"Integrative, multimodal nursing intervention for uncontrolled hypertension: randomized controlled trial effects on blood pressure, perceived stress, and medication adherence.","authors":"Ayşe Dağıstan Akgöz, Sebahat Gözüm","doi":"10.5646/ch.2026.32.e6","DOIUrl":"10.5646/ch.2026.32.e6","url":null,"abstract":"<p><strong>Background: </strong>Uncontrolled hypertension is a major modifiable risk factor for cardiovascular diseases. This study evaluated the effectiveness of the Uncontrolled Hypertension Treatment Intervention in Nursing Model (UHTINuM), a nurse-led, integrative, multimodal intervention combining yoga, adherence education, and home blood pressure (BP) monitoring.</p><p><strong>Methods: </strong>In this single-blind, randomized controlled trial, 48 adults aged 50-65 years with uncontrolled hypertension were randomized 1:1 to receive either the 12-week UHTINuM program or usual care. The intervention included structured group yoga sessions, individualized adherence education, and home BP self-monitoring with telefeedback. Primary outcomes were systolic and diastolic BP, perceived stress, and medication adherence. Secondary outcomes were body mass index (BMI) and physical activity level. Analyses were conducted using the intention-to-treat principle.</p><p><strong>Results: </strong>Compared with controls, the intervention group achieved significantly greater reductions in systolic BP (mean difference = -21.8 mmHg; 95% confidence interval [CI], -25.9 to -17.6) and diastolic BP (-11.4 mmHg; 95% CI, -14.9 to -7.9). Perceived stress decreased by -4.2 points (95% CI, -6.3 to -2.1), and adherence improved by -3.1 points (95% CI, -4.8 to -1.3). Secondary outcomes also favored the intervention group, with a modest reduction in BMI (-0.7 kg/m²; 95% CI, -1.1 to -0.3) and a shift from inactive to minimally active physical activity levels in 58% of participants.</p><p><strong>Conclusions: </strong>The multimodal, nurse-led UHTINuM intervention integrating yoga, education and self-monitoring significantly improved BP control, reduced stress and enhanced medication adherence in middle-aged adults with uncontrolled hypertension. Implementing similar integrative strategies could bolster community hypertension management.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04809519.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e6"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141222","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":"Approaches to deprescribing cardiovascular medications in patients receiving palliative care: a scoping review.","authors":"Gabriela Perez-Tamayo, Mohit Sirole, Elizabeth Fernandez, Krystel Chedid, Iram Sirajuddin, Rajesh Jha","doi":"10.5646/ch.2026.32.e3","DOIUrl":"10.5646/ch.2026.32.e3","url":null,"abstract":"<p><p>This scoping review conducted from April 1, 2025, to May 31, 2025, aims to use palliative care as a valuable opportunity to reduce polypharmacy and enhance patient-centered care in the final days of life. To conduct this scoping review with systematic components, a database search was conducted on PubMed and EBSCO to identify studies focused on deprescribing cardiovascular medications in patients subject to polypharmacy in nursing homes. Eligible studies were inclusive of human patients aged 65 and older, patients receiving palliative care or with a limited life expectancy and focused on examining the effects of deprescribing practices and other outcomes affected. Study quality was assessed using the Cochrane Risk of Bias assessment tools RoB-2 and ROBINS-I. The quality assessment was performed by two reviewers, and discretion was discussed until consensus was achieved. In total, 31 studies met the inclusion criteria and were included in the discussion of the review, and 11 of those were included in the quantitative data analysis. There was a notable variation in both baseline medication uses and rates of discontinuation seen across the studies. Rates of deprescribing for antihypertensives varied widely, reported as low as 16.6% in large retrospective cohort studies and as high as 87.8% in structured intervention trials using specified guideline tools such as STOPPFrail. Deprescribing should be routine in palliative assessments, guided by frameworks that consider prognosis, symptoms, and patient values. Limitations of this scoping review include heterogeneity of the studies, which limits direct comparability between them and difficulty in generalizing the findings to a broader palliative care population and assessing the quality of life (QoL) as only a few studies used a validated instrument or patient outcome, but not all were able to assess them in the same manner. Due to the need for properly structured deprescribing guidelines, physicians lack the time and tools to utilize shared decision making to their advantage in many places. The findings from this review suggest that a tailored deprescribing strategy could effectively complement traditional pharmacological treatments by decreasing potential adverse effects and medication burden in vulnerable populations, especially those diagnosed with cardiovascular disease.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e3"},"PeriodicalIF":3.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965433","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":"Retraction: The utility of biomarker risk prediction score in patients with chronic heart failure.","authors":"Alexander E Berezin, Alexander A Kremzer, Yulia V Martovitskaya, Tatyana A Berezina, Tatyana A Samura","doi":"10.5646/ch.2026.32.e2","DOIUrl":"https://doi.org/10.5646/ch.2026.32.e2","url":null,"abstract":"<p><p>[This retracts the article 3 in vol. 22, PMID: 26973794.].</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"32 ","pages":"e2"},"PeriodicalIF":3.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145964716","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}