High Blood Pressure & Cardiovascular Prevention最新文献

{"title":"Association Between Naples Prognostic Score and All-Cause Mortality in Individuals with Cardio-Renal-Metabolic Multimorbidity: A Cohort Study.","authors":"Song Wen, Wei Shi, Xingjie Huang, Zhexuan Deng, Hua Yang, Nan Chen, Lingbing Meng","doi":"10.1007/s40292-026-00803-7","DOIUrl":"https://doi.org/10.1007/s40292-026-00803-7","url":null,"abstract":"<p><strong>Introduction: </strong>The Naples Prognostic Score (NPS) has demonstrated prognostic value in oncology and certain chronic diseases. Its utility in cardio-renal-metabolic multimorbidity (CRMM) remains unexplored.</p><p><strong>Aim: </strong>This study aims to evaluate the association between NPS and all-cause mortality in individuals with CRMM.</p><p><strong>Methods: </strong>We analyzed data from the National Health and Nutrition Examination Survey (1999-2018) comprising 3,602 adults with CRMM. The NPS was derived from serum albumin, total cholesterol (TC), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR). Weighted Cox proportional hazards models and restricted cubic spline (RCS) analysis were used to evaluate associations between NPS and all-cause mortality.</p><p><strong>Results: </strong>Over a median follow-up of 79 months, 1,621 (41.4%) deaths occurred. After comprehensive adjustment for potential confounders, each 1-point increase in NPS was associated with a 24.6% higher risk of all-cause mortality (HR 1.246, 95% CI 1.150-1.350, P < 0.0001). The HRs for all-cause mortality was 1.133 (95 % CI: 0.846-1.518, P = 0.401) in the medium NPS group and 1.721 (95 % CI: 1.248-2.375, P = 0.0009) in the high NPS group, as compared with the low NPS group. RCS analysis indicated a nonlinear relationship between NPS and all-cause mortality among participants with CRMM (Pnonlinear=0.014). Weighted quantile sum regression analysis identified NLR as the primary contributor to mortality risk (weight: 0.612 at 2 years, 0.580 at 5 years), followed by TC.</p><p><strong>Conclusion: </strong>This study identified a positive, nonlinear association between NPS and all-cause mortality in CRMM individuals. The NPS integrates inflammatory, metabolic, and nutritional biomarkers into a practical prognostic tool that may enhance risk stratification and guide personalized management in multimorbidity.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Determinants of Pulse Wave Velocity in Super Normal Vascular Aging (SUPERNOVA) Patients.","authors":"Christina Antza, Nikolaos Kakaletsis, Eugenia Gkaliagkousi, Christos Savopoulos, Vasilios Kotsis","doi":"10.1007/s40292-026-00801-9","DOIUrl":"https://doi.org/10.1007/s40292-026-00801-9","url":null,"abstract":"<p><strong>Introduction: </strong>Super Normal Vascular Aging (SUPERNOVA) describes individuals whose vascular system remains protected, despite exposure to cardiovascular risk factors. Understanding the determinants of arterial stiffness in this population may provide valuable insights into protection mechanisms.</p><p><strong>Aim: </strong>This study aims to investigate the key features of SUPERNOVA individuals and examine factors associated with carotid-femoral pulse wave velocity (cf-PWV) across different age subgroups.</p><p><strong>Methods: </strong>This cross-sectional study included individuals referred to a Hypertension Center for blood pressure (BP) evaluation. SUPERNOVA status was defined based on cf-PWV values lower than the age-expected averages derived from European population. Clinical, laboratory, and ambulatory BP measurements were recorded.</p><p><strong>Results: </strong>From a total cohort of 829 participants, 37.2% (n = 308) met the SUPERNOVA criteria. The mean age was 42.7 ± 25years (57.9% females). The population present normal BP parameters during day, night and 24 h, almost in all age decades. The mean cf-PWV presented the lowest value (5.2 ± 0.5 m/s) for the youngest age group (< 30years) and the highest (9.3 ± 1.0 m/s) for the older (≥ 70years). The prevalence of hypertension, obesity, smoking, and dyslipidemia was lower among elderly SUPERNOVA individuals (≥ 70years) compared to younger groups. Multivariate analysis revealed that age (B: 0.06, p < 0.001), LDL cholesterol (B: 0.009, p = 0.001), and 24-hour systolic BP (B: 0.031, p = 0.005) were independently associated with higher cf-PWV, whereas 24-hour diastolic BP (B: - 0.047, p = 0.003) was inversely associated among SUPERNOVA patients.</p><p><strong>Conclusion: </strong>This study highlights key characteristics of SUPERNOVA individuals and suggests that LDL cholesterol and 24-hour systolic BP are crucial factors influencing arterial stiffness. These findings may help identify strategies to preserve vascular health and delay arterial aging.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Symptoms of Anxiety and Depression and Blood Pressure Variability in Older Outpatients.","authors":"Roberto Presta, Giulia Rivasi, Alice Ceccofiglio, Sara Rogani, Laura Orlandi, Ludovica Ceolin, Luigi Scavino, Alessandro Mengozzi, Enrico Brunetti, Chiara Mussi, Agostino Virdis, Andrea Ungar, Mario Bo","doi":"10.1007/s40292-026-00797-2","DOIUrl":"https://doi.org/10.1007/s40292-026-00797-2","url":null,"abstract":"<p><strong>Introduction: </strong>Blood pressure variability (BPV) predicts cardiovascular risk beyond average BP, but evidence on the role of anxiety/depression on BPV in older adults is limited.</p><p><strong>Aim: </strong>To evaluate the association of anxiety and depressive symptoms with short-term BPV and white-coat effect (WCE) in older outpatients undergoing ambulatory blood pressure monitoring (ABPM).</p><p><strong>Methods: </strong>Cross-sectional multicenter study of outpatients aged ≥ 65 years undergoing 24-h ABPM across Italian geriatric centers. Anxiety and depressive symptoms were assessed with GAD-7, STAI-Y1/Y2 and GDS-15. Short-term BPV was quantified by daytime systolic average real variability (ARV). The office-daytime BP difference was calculated (ΔSBP and ΔDBP), and WCE was defined categorically as ΔSBP ≥ 20 mmHg and/or ΔDBP ≥ 10 mmHg. Multivariable models were adjusted for clinical and pharmacological confounders.</p><p><strong>Results: </strong>Among 235 outpatients (median age 76.4 years, 60.0% female), anxiety prevalence varied widely by scale (GAD-7: 34.9%; STAI-Y1: 74.0%; STAI-Y2: 73.2%), while depressive symptoms were present in 28.5%. ARV did not significantly differ in patients screening positive or negative for anxiety (GAD-7: 16.4 vs 15.5 mmHg, p = 0.349; STAI-Y1: 16.2 vs 14.9 mmHg, p = 0.214; STAI-Y2: 16.2 vs 14.8 mmHg, p = 0.160), or between those with and without depressive symptoms (15.9 vs 15.8 mmHg, p = 0.902); also, after adjustment for potential confounders. WCE prevalence was 40.9% and was higher in participants screening negative for depressive symptoms (39.2% vs 23.9%, p = 0.039). ΔSBP tended to be higher in participants screening negative for anxiety (GAD-7: 7.6 vs 3.3 mmHg, p = 0.095) and depressive symptoms (GDS-15: 7.6 vs 2.6 mmHg, p = 0.065).</p><p><strong>Conclusions: </strong>Anxiety and depressive symptoms were not independently associated with short-term BPV in older outpatients. WCE/ΔSBP were generally higher, albeit non significantly, in participants without anxiety or depression. These findings suggest that psychological symptoms may contribute only modestly to short-term BP fluctuations in older adults.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Non-statin Lipid-Lowering Therapies Implementation and Statin Treatment Intensification on Lipid Status in Heart Transplant Recipients: A Single-Centre Retrospective Cohort Study.","authors":"Daniela Bacich, Enrico Giuseppe Italiano, Marika Faggioli, Laura Rizzo, Nicola Pradegan, Giuseppe Toscano, Chiara Tessari, Vincenzo Tarzia","doi":"10.1007/s40292-026-00794-5","DOIUrl":"https://doi.org/10.1007/s40292-026-00794-5","url":null,"abstract":"<p><strong>Introduction: </strong>Statin therapy up-titration is hindered in heart-transplant (HT) recipients due to concern for pharmacological interactions and side effects. Alternative lipid lowering therapies (LLT) are now available for patients who are poorly tolerant to statins or those with significant dyslipidaemia despite maximal dose statin treatment and dietary advice. Real-world studies with non-statin LLT are limited in HT population.</p><p><strong>Aim: </strong>To examine the lipid status of HT patients following the increased adoption of non-statin lipid lowering therapies.</p><p><strong>Methods: </strong>Single centre retrospective observational cohort study including adult HT patients under follow-up in a tertiary centre. From August 2024 to March 2025, 238 patients had lipid profile, prevalence of statin and non-statin LLT prescription assessed and compared to the same data measured in 2019/2020.</p><p><strong>Results: </strong>Patients had a median age of 64 (IQR=53.3-72.0) years, 27% were female. Median LDL-C levels for paired values significantly decreased from 109.6 [88.9-133.0] to 93.8 [72.5-112.0] at last follow up (p<0.001). The proportion of patients receiving ezetimibe sharply increased [73 (30.7%) compared to 27 (11.3%), p<0.001]; 10 patients (4.2%) were receiving proprotein convertase subtilisin/kexin type 9 inhibitor monoclonal antibodies (PCSK9i), 3 (1.3%) inclisiran, 3 (1.3%) bempedoic acid, which were not commercially available at the time of the previous assessment. Also, the proportion of patients receiving statins increased during follow-up [145 (60.9%) vs 128 (52.1%), p<0.001], mainly because of high-intensity statin adoption.</p><p><strong>Conclusion: </strong>In a real-world cohort of HT recipients, increased adoption of ezetimibe, PCSK9-targeting therapies and bempedoic acid combined with intensification of statin therapy safely and efficiently reduced LDL-C.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracoscopic Sympathectomy in Treatment-Resistant Essential Hypertension: A Novel Approach to Reduce Sympathetic Activity and Blood Pressure.","authors":"Mark Reinhard, Amal Derai, Niels Henrik Buus, Per Løgstrup Poulsen, Morten Bendixen, Peter Juhl-Olsen, Kent Lodberg Christensen","doi":"10.1007/s40292-026-00792-7","DOIUrl":"https://doi.org/10.1007/s40292-026-00792-7","url":null,"abstract":"","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Albumin/Globulin Ratio for Mortality in Stage 2 Cardiovascular-Kidney-Metabolic Syndrome: A Nationwide Cohort Analysis (1999-2018).","authors":"Ciai Chen, Shanni Ding, Yao Wang, Shuo Sun, Jie Zhang, Wanjuan Qiu, Jiani Ruan, Liqing Chen, Hongying Pan","doi":"10.1007/s40292-025-00779-w","DOIUrl":"https://doi.org/10.1007/s40292-025-00779-w","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome represents a complex interplay of metabolic dysfunction, cardiovascular disease, and chronic kidney disease, with stage 2 characterized by metabolic risk factors and subclinical organ damage. The albumin/globulin ratio (AGR), which integrates inflammatory and nutritional status, has shown prognostic value in chronic diseases; however, its role in stage 2 CKM syndrome remains unexplored.</p><p><strong>Aim: </strong>To evaluate the prognostic value of AGR for all-cause, cardiovascular, and cancer mortality among adults with stage 2 CKM syndrome.</p><p><strong>Methods: </strong>This nationwide cohort analysis included 13,148 adults with stage 2 CKM syndrome from NHANES (1999-2018). Participants were categorized by AGR levels (≤ 1.286, 1.286-1.500, > 1.500). Mortality outcomes were ascertained through linkage to the National Death Index up to 2019. Cox proportional hazards models were used to assess the associations between AGR and mortality, adjusting for sociodemographic, lifestyle, and clinical factors.</p><p><strong>Results: </strong>Higher AGR levels demonstrated significant inverse associations with mortality. Restricted cubic spline analysis revealed a significant inverse relationship for all-cause mortality (P for overall < 0.01), characterized by a threshold effect whereby mortality risk increased significantly when AGR fell below approximately 1.4. Compared to the lowest AGR group, the highest group (> 1.500) showed 35% lower all-cause mortality (HR = 0.65, 95% CI 0.52-0.80), 47% lower cardiovascular mortality (HR = 0.53, 95% CI 0.34-0.84), and 45% lower cancer mortality (HR = 0.55, 95% CI 0.36-0.84). Subgroup analysis showed that the predictive role of AGR was particularly evident in males, individuals < 65 years, current smokers, and those who were non-overweight (BMI < 25 kg/m²).</p><p><strong>Conclusion: </strong>AGR is a robust, independent predictor of all-cause, cardiovascular, and cancer mortality in adults with stage 2 CKM syndrome. The association with all-cause mortality exhibits a significant threshold effect, highlighting the importance of maintaining AGR above approximately 1.4. These findings support the use of AGR for early risk stratification and personalized management in this population.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to Hypertension Medications During the First Year of Treatment in Elderly Patients and its Effect on Clinical Outcomes.","authors":"Ophir Lavon, Sinan Omri","doi":"10.1007/s40292-026-00787-4","DOIUrl":"https://doi.org/10.1007/s40292-026-00787-4","url":null,"abstract":"<p><strong>Introduction: </strong>Adherence to antihypertensive medications is essential to ensure therapeutic effectiveness. However, the long-term clinical impact of adherence during the first year of treatment in elderly patients remains uncertain.</p><p><strong>Aim: </strong>To evaluate the level of adherence to antihypertensive therapy during the first year following diagnosis in elderly patients and to assess its long-term clinical implications.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients aged ≥ 65 years with newly diagnosed essential hypertension. Medication adherence during the first year after diagnosis was assessed using the proportion of days covered (PDC). Clinical outcomes-including myocardial infarction, stroke, and all-cause mortality-were evaluated beyond the first year, with an average follow-up of 108 months. Data were extracted from the electronic medical records of a large community-based healthcare provider.</p><p><strong>Results: </strong>A total of 2934 patients were included in the analysis. The mean age was 72.4 years, and approximately 60% were women. Among the cohort, 21.3% had a PDC of less than 70%. Adherence above the 70% threshold was significantly associated with a reduced incidence of stroke (HR = 0.59; 95% CI 0.37-0.94; p = 0.028).</p><p><strong>Conclusions: </strong>Higher adherence (≥ 70%) to antihypertensive therapy during the first year of treatment in elderly patients was associated with a significantly lower incidence of stroke in subsequent years. These findings highlight the importance of early adherence and support the need for targeted interventions to promote sustained medication use, even in older populations.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147527780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Organ Damage in Young Adults with Cryptogenic Ischaemic Stroke: The SECRETO Study.","authors":"Rune Krogh Eilertsen, Eva Gerdts, Ulrike Waje-Andreassen, Dana Cramariuc, Rasmus Bach Sindre, Jani Pirinen, Satu Suihko, Tomi Sarkanen, Marko Virtanen, Essi Ryödi, Pekka Jäkälä, Marja Hedman, Petra Redfors, Odd Bech-Hanssen, Juha Huhtakangas, Pauli Ylikotila, Riikka Lautamäki, Antti Saraste, Bettina von Sarnowski, Raila Busch, Ana Catarina Fonseca, Ana G Almeida, Patricia Martínez-Sánchez, Janika Kõrv, Piibe Muda, Phillip Ferdinand, Cheryl Oxley, Diana Zakarkaitė, Kristina Ryliškienė, Nicolas Martinez-Majander, Juha Sinisalo, Jukka Putaala, Helga Midtbø","doi":"10.1007/s40292-026-00789-2","DOIUrl":"https://doi.org/10.1007/s40292-026-00789-2","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac organ damage (OD) is associated with increased risk of cardiovascular disease. However, limited knowledge exists on cardiac OD in young patients with cryptogenic ischaemic stroke (CIS).</p><p><strong>Aim: </strong>To explore prevalence and covariates of cardiac OD in patients with CIS compared to controls participating in the SECRETO study.</p><p><strong>Methods: </strong>We analysed data from 427 patients with CIS aged <50 years and 361 age- and sex-matched controls. OD was defined as presence of abnormal left ventricular (LV) geometry (LV hypertrophy or concentric remodelling) or left atrial enlargement (LAE) assessed by echocardiography, using sex-specific threshold values.</p><p><strong>Results: </strong>Compared to controls, patients had higher prevalences of obesity and tobacco smoking, patent foramen ovale (PFO) (52% vs. 25%) and abnormal LV geometry (12% vs. 7%, all p < 0.01), while presence of LAE did not differ. In multivariable analyses, CIS was associated with presence of abnormal LV geometry (odds ratio 1.86 [95% confidence interval 1.09-3.20], p=0.024). In separate multivariable analyses in patients only, obesity was associated with both abnormal LV geometry and LAE (both p < 0.01), and higher systolic blood pressure only with presence of abnormal LV geometry (p < 0.001). No significant association with PFO was found.</p><p><strong>Conclusion: </strong>In young patients with CIS participating in the SECRETO study, abnormal LV geometry was more prevalent compared to age- and sex-matched controls and associated with presence of higher blood pressure and obesity. The results point to the importance of blood pressure and weight control in CIS to prevent progression of cardiac OD and recurrent cardiovascular events.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147527994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Functional Reserve and Its Association with eGFR Trajectories and Blood Pressure Patterns in Hypertensives with Preserved Renal Function.","authors":"Aikaterini Damianaki, Kyriakos Dimitriadis, Emelina Stambolliu, Panagiotis Iliakis, Dimitrios Konstantinidis, Konstantinos Tsioufis, Dimitrios Petras","doi":"10.1007/s40292-026-00782-9","DOIUrl":"https://doi.org/10.1007/s40292-026-00782-9","url":null,"abstract":"<p><strong>Introduction: </strong>Renal Functional Reserve (RFR) is a promising marker for detecting early nephron loss and functional renal mass.</p><p><strong>Aim: </strong>We evaluated the relationship between RFR and changes in eGFR over time in hypertensive (HT) and normotensive (NT) individuals.</p><p><strong>Methods: </strong>In this 24-month prospective study, newly diagnosed essential HT and NT individuals with eGFR ≥60 ml/min/1.73m² were included. At baseline, RFR was measured by endogenous creatinine clearance after an oral protein load in both groups, alongside 24-hour ambulatory blood pressure (BP) profile in HT. Serum creatinine was reassessed at months 12 and 24.</p><p><strong>Results: </strong>A total of 51 HT and 20 NT subjects (mean age 53.2 ± 12.1 and 54.3 ± 10.0 years) completed the study. RFR levels did not differ between groups (25.1 ± 18.7 vs. 27.7 ± 15.7 ml/min, p = 0.6). No significant difference was found in the annual and the two-year eGFR change between HT and NT. At 24 months, HT and NT with RFR ≥30 ml/min showed less pronounced declines in eGFR compared to those with RFR <30 ml/min (0.5 ± 2.6 vs. - 1.4 ± 1.7 ml/min/1.73m², p =0.002 and - 0.6±1.3 vs. - 1.6 ± 0.7 ml/min/1.73m², p = 0.02 respectively). HT with high RFR were more frequently dippers (64.4% vs. 34.4%, p < 0.05).</p><p><strong>Conclusions: </strong>RFR does not differ between HT and NT with preserved renal function but normal RFR is associated with slower eGFR decline. Reduced RFR correlates with non-dipping BP in HT.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of regional and whole body sympathetic normalization during antihypertensive drug treatment: a potential link for the residual risk.","authors":"Guido Grassi, Rita Facchetti, Ana Jelakovic, Cesare Cuspidi","doi":"10.1007/s40292-026-00786-5","DOIUrl":"https://doi.org/10.1007/s40292-026-00786-5","url":null,"abstract":"<p><strong>Introduction: </strong>It is unknown whether the failure of antihypertensive drug treatment to normalize sympathetic cardiovascular (CV) function reported in previous studies selectively affects regional sympathetic CV outflow or it also involves whole body neuroadrenergic drive.</p><p><strong>Aim: </strong>The present study examines the impact of antihypertensive drug treatment on regional and whole body sympathetic CV influences.</p><p><strong>Methods: </strong>Fifthyfour essential hypertensive patients were included in the study. In each patient measurements consisted of the microneurographic recording of muscle sympathetic nerve traffic (MSNA) and the assay of venous plasma norepinephrine (NE). They were performed before and during an antihypertensive drug treatment (monotherapy or two-drugs combination) prolonged for a 3 months period. Measurements were also carried out in 31 age-matched normotensive controls.</p><p><strong>Results: </strong>In the study population antihypertensive drug treatment lowered clinic blood pressure to values <140/90 mmHg and significantly (P<0.001) reduced both MSNA and NE. However, during treatment the values of these two adrenergic markers remained significantly greater (+70.8 % and +64.4%, respectively) than those detected in the normotensive subjects.</p><p><strong>Conclusions: </strong>These data provide evidence that antihypertensive drug treatment reduces but not normalizes regional and whole body sympathetic CV drive, likely participating at determining the residual CV risk reported in different studies in treated hypertensives.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}