High Blood Pressure & Cardiovascular Prevention最新文献

{"title":"Atherogenic Index of Plasma as Predictor for Cardiovascular Events and Cardiometabolic Diseases:Findings from the PAMELA Study.","authors":"Alessandro Maloberti, Rita Facchetti, Ana Jelakovic, Cesare Cuspidi, Guido Grassi","doi":"10.1007/s40292-026-00807-3","DOIUrl":"10.1007/s40292-026-00807-3","url":null,"abstract":"<p><strong>Introduction: </strong>The Atherogenic Index of Plasma (AIP), ratio between triglycerides and high-density lipoprotein cholesterol, has been associated with cardiovascular (CV) events, metabolic syndrome and hypertension (HT)-related vascular organ damage. However, the majority of the published studies suffer from important limitations, such as the cross-sectional or retrospective nature and the performance in selected Asian populations only.</p><p><strong>Aim: </strong>We performed a data analysis in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study, examining longitudinally the relationships between AIP, diabetes mellitus (DM), HT and left ventricular hypertrophy (LVH) in a western European general population.</p><p><strong>Methods: </strong>At the study entry baseline data were collected in 2035 subjects, while longitudinal data were obtained in 1412 subjects examined for a median follow-up time lasting 10.7 years.</p><p><strong>Results: </strong>50.6% of the subjects were males, aged 50.9 ± 13.7 (mean ± SD) yrs. During the follow-up AIP did not significantly change (from - 0.11 ± 0.3 to - 0.12 ± 0.29 a.u., P = NS), while systolic BP and plasma glucose significantly increased, with a significant relationship with HT, DM and LVH development (P < 0.0001). At multivariable analysis, AIP significantly and independently predicted the above-mentioned outcomes, with the exception of HT development based on home BP. The same significant association was detected for fatal and non-fatal CV events.</p><p><strong>Conclusions: </strong>These data provide evidence that in a general European population characterized by a low CV risk AIP significantly and independently predicts HT, DM and LVH development and is significantly associated with the composite outcome of CV morbidity and mortality.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"593-603"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143408","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 of Dietary Inflammatory Index and Dietary Oxidative Balance Score with Mortality Among Individuals with Cardiovascular-Kidney-Metabolic Syndrome.","authors":"Xiaohua Wang, Hewanmeng Geng, Zihang Yue, Jiaqi Zhang, Siyu Liu, Chengxiang Hu, Zhirong Li, Yue He, Yanan Ma, Lina Jin","doi":"10.1007/s40292-026-00820-6","DOIUrl":"https://doi.org/10.1007/s40292-026-00820-6","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome represents a complex interplay of cardiovascular, kidney, and metabolic disorders. Dietary factors, particularly those with pro-inflammatory and pro-oxidant properties, may influence disease progression and mortality, yet their role in the CKM syndrome population remains underexplored.</p><p><strong>Aim: </strong>To evaluate potential associations of the dietary inflammatory index (DII), the dietary oxidative balance score (DOBS), and mortality in individuals with CKM syndrome.</p><p><strong>Methods: </strong>A total of 17,317 individuals with CKM syndrome were enrolled and stratified into three groups: stage 0, stages 1-3, and stage 4. DII and DOBS were derived from 26 and 16 preselected dietary components, respectively. Kaplan-Meier analysis, Cox proportional-hazards models, and forest plots were used to examine the associations between dietary scores and mortality across CKM stages.</p><p><strong>Results: </strong>No significant associations were found in stage 0. In stages 1-3 and 4, pro-inflammatory/pro-oxidant diets were associated with increased mortality, with HRs for all-cause, cardiovascular, and non-cardiovascular mortality of 1.46 (1.10-1.94), 1.42 (0.70-2.87), and 1.47 (1.09-1.98) in stages 1-3, and 2.07 (1.33-3.20), 2.20 (1.06-4.59), and 2.01 (1.25-3.24) in stage 4, respectively.</p><p><strong>Conclusions: </strong>Pro-inflammatory and pro-oxidant dietary patterns, as measured by DII and DOBS, are associated with an increased risk of all-cause and non-cardiovascular mortality in both CKM stages 1-3 and stage 4, and with cardiovascular mortality specifically in stage 4. No significant association with cardiovascular mortality was observed in stages 1-3.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792181","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":"Pathophysiology and Clinical Relevance of Microvascular Remodeling in Arterial Hypertension.","authors":"Matteo Lemoli, Claudia Agabiti Rosei, Giacomo Buso, Claudia Rossini, Luigi Mori, Damiano Rizzoni, Massimo Salvetti, Maria Lorenza Muiesan, Carolina De Ciuceis","doi":"10.1007/s40292-026-00813-5","DOIUrl":"https://doi.org/10.1007/s40292-026-00813-5","url":null,"abstract":"<p><p>Long-term exposure to high blood pressure leads to systemic structural and functional changes of microcirculation, a condition named microvascular remodeling. Microvascular remodeling can be assessed in subcutaneous small resistance arteries or non-invasively at the retinal level using Scanning Laser Doppler Flowmetry and Adaptive Optics. Capillary rarefaction is also a marker of hypertensive vascular impairment resulting in a lack of nutrient and oxygen supply. In hypertension, microvascular remodeling and large artery damage are part of a vicious cycle that eventually leads to target organ damage and worsen cardio-renal-cerebrovascular outcomes. This review describes the inflammatory nature of microvascular remodeling and aims to unravel the association of microvascular remodeling with hypertension-mediated organ damage, also providing an overview on its clinical relevance.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630388","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":"Efficacy and Safety of the Extemporaneous Combination Nebivolol/Amlodipine in Patients with Hypertension Uncontrolled on Monotherapy: The BOTTICELLI Study.","authors":"Massimo Volpe, Giovambattista Desideri, Ralf Dechend, Philippe Van De Borne, Simone Baldini, Suada Meto, Paolo Fabrizzi, Lorenzo Melani, Giorgio Reggiardo, Giuseppe Mancia","doi":"10.1007/s40292-026-00816-2","DOIUrl":"https://doi.org/10.1007/s40292-026-00816-2","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is the leading cause of cardiovascular disease, and its complications are preventable with blood pressure (BP)-lowering treatment. Combination treatment with 2 or more antihypertensive agents achieves sustained BP reductions. Nebivolol (NEB), a highly β1-selective beta-blocker with vasodilating properties, and amlodipine (AML), a dihydropyridine calcium channel blocker, are widely prescribed as monotherapies or in combination.</p><p><strong>Aim: </strong>To evaluate efficacy and safety of extemporaneous combination at fixed doses of NEB/AML in adults with hypertension uncontrolled on monotherapy.</p><p><strong>Methods: </strong>This phase 4, open-label, multicentre study enrolled adults with hypertension uncontrolled on monotherapy. After 4-week run-in on NEB 5 mg or AML 5 mg, patients with uncontrolled BP initiated NEB/AML 5/5 mg. Those still uncontrolled after 4 weeks were up-titrated to NEB/AML 5/10 mg, while controlled patients continued NEB/AML 5/5 mg for the full 8-week period. The primary endpoint was the change from baseline in mean sitting DBP after 8 weeks of treatment. Secondary endpoints included the change from baseline in mean sitting SBP, the proportion of patients achieving guideline-recommended BP targets, and safety.</p><p><strong>Results: </strong>A total of 301 patients, mean age 52.1 (± 8.5) years, entered the run-in period; of these, 276 completed the study, with 182 achieving goal BP on NEB/AML 5/5 mg and 94 up-titrated to NEB/AML 5/10 mg. Overall, mean sitting DBP decreased by -15.2 (± 8.3) mmHg and SBP by -24.2 (± 11.8) mmHg (both p<0.001) over the treatment period. At study end, 63.0% of patients achieved BP <130/80 mmHg. NEB/AML dose regimens were well tolerated, and no serious treatment-emergent adverse events were reported.</p><p><strong>Conclusion: </strong>This study adds to the existing evidence supporting the efficacy and safety of the NEB/AML combination at two dose levels in managing hypertension and bringing patients at target goal.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648518","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":"Efficacy and Safety of SGLT-2 Inhibitors in Patients with Uncontrolled or Resistant Hypertension: A Pilot Meta-Analysis of Randomized Clinical Trials.","authors":"Omer Mohammed, Sun Hyeok Kim, Aditya Karthikeyan, Nehal Eid, Raissa Santos Reimann, Afthab Salam Kanniyan, Basil Joy, Ana-Cătălina Dascălu, Giovanni J Nanna, Laura Marcela Romero-Acero, Michele Nanna","doi":"10.1007/s40292-026-00817-1","DOIUrl":"https://doi.org/10.1007/s40292-026-00817-1","url":null,"abstract":"<p><strong>Introduction: </strong>Resistant or poorly controlled hypertension is a major contributor to cardiovascular morbidity and mortality despite contemporary multidrug regimens.</p><p><strong>Aim: </strong>This study aimed to evaluate the efficacy and safety of SGLT-2 inhibitors as adjunctive agents to standard antihypertensive therapy in this high-risk population.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Google Scholar, the Cochrane Library, ScienceDirect, and ClinicalTrials.gov for randomized controlled trials (RCTs) assessing SGLT-2 inhibitors in adults with poorly controlled hypertension (on ≥2 antihypertensive agents) or resistant hypertension. Primary outcome was the mean change in office systolic blood pressure (SBP). Mean differences (MDs) were pooled for continuous outcomes, and risk ratios (RRs) were pooled for dichotomous outcomes using random-effects models.</p><p><strong>Results: </strong>Four RCTs (n=3,718) were included in the meta-analysis. SGLT-2 inhibitors significantly reduced office SBP in both the short term (MD -3.29 mmHg, 95% CI -3.96 to -2.62) and long term (MD -2.96 mmHg, 95% CI -3.58 to -2.35). The overall incidence of adverse events (pooled RR: 0.99, 95% CI 0.95 to 1.02), serious adverse events (pooled RR: 0.92, 95% CI 0.84 to 1.00), AKI (pooled RR: 0.98, 95% CI 0.80 to 1.21), and UTI (pooled RR: 0.88, 95% CI 0.36 to 2.17) were comparable between groups. However, SGLT-2 inhibitors were associated with a significantly increased risk of volume depletion, hypotension, and genital infections.</p><p><strong>Conclusion: </strong>SGLT-2 inhibitors provide a modest incremental benefit in lowering office SBP for patients with uncontrolled or resistant hypertension on multidrug regimens with an overall acceptable safety profile. Future dedicated RCTs are warranted.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648500","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":"Pregnancy as a Window for Hypertension and Cardiovascular Prevention in Women: A Life-Course Perspective Based on the 2025 ESC Guidelines.","authors":"Anna Vittoria Mattioli, Giulia Renda, Claudio Ferri, Sabina Gallina, Claudio Borghi","doi":"10.1007/s40292-026-00815-3","DOIUrl":"https://doi.org/10.1007/s40292-026-00815-3","url":null,"abstract":"<p><p>The 2025 European Society of Cardiology (ESC) Guidelines on cardiovascular disease in pregnancy introduce a life-course approach to cardiovascular prevention, extending risk assessment and management from preconception through the postpartum period. Beyond the management of established cardiovascular disease, the guidelines emphasize the importance of identifying modifiable risk factors and pregnancy-related complications as early markers of future cardiovascular risk. This narrative mini-review provides a prevention-oriented interpretation of the 2025 ESC Guidelines, focusing on their implications for hypertension prevention and long-term cardiovascular health in women. Pregnancy is increasingly recognized as a biological stress test capable of unmasking latent cardiometabolic and vascular vulnerability, while adverse pregnancy outcomes, including preeclampsia, gestational hypertension, gestational diabetes, fetal growth restriction, and preterm delivery, represent important predictors of future hypertension and cardiovascular disease. Particular emphasis is placed on preconception cardiovascular assessment, lifestyle optimization, obesity management, and the cardiovascular implications of assisted reproductive technologies. The Pregnancy Heart Team is discussed as a multidisciplinary model for integrating cardiovascular and obstetric care across the reproductive continuum. In addition, we propose a practical life-course prevention framework incorporating structured postpartum surveillance, blood pressure monitoring, cardiometabolic screening, and long-term follow-up after adverse pregnancy outcomes. By translating contemporary ESC recommendations into a clinically applicable prevention strategy, this review highlights pregnancy as a unique opportunity for early cardiovascular risk identification and implementation of sex-specific preventive interventions aimed at reducing the future burden of hypertension and cardiovascular disease in women.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455744","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":"Orthostatic Hypotension in Hypertensive Patients Hospitalized in Italian Internal Medicine Departments: FADOI-HYP-OP Study.","authors":"Claudio Ferri, Alberto Mazza, Dario Manfellotto, Francesco Dentali, Alberto Moggi Pignone, Maria D'Avino, Roberta Buso, Antonella Valerio, Maria Lorenza Muiesan, Giovanbattista Desideri, Martino Pengo, Grzegorz Bilo, Gianfranco Parati, Andrea Fontanella","doi":"10.1007/s40292-026-00808-2","DOIUrl":"https://doi.org/10.1007/s40292-026-00808-2","url":null,"abstract":"<p><strong>Introduction: </strong>Orthostatic hypotension (OH) is defined as a decline in systolic blood pressure of at least 20 mmHg or a reduction in diastolic blood pressure of at least 10 mmHg, within the first 3 min of standing.</p><p><strong>Aim: </strong>To evaluate the prevalence of OH and to identify the characteristics of patients with OH in hypertensive patients hospitalized in medical inpatient departments.</p><p><strong>Methods: </strong>A multicenter, observational, prospective study (FADOI-HYP-OP) included 1000 hypertensive inpatients from 29 Departments throughout Italy. Demographic, clinical data, blood pressure and the presence of comorbidities were recorded at baseline. Factors associated with OH were assessed in multiple logistic regression analysis.</p><p><strong>Results: </strong>The prevalence of OH was 25.1%. Factors independently associated with OH included disturbances of consciousness (RR 1.56, 95%CI 1.10-2.20; p = 0.01), Parkinson's disease (RR 2.30, 95%CI 1.47-3.59; p = 0.0002), type-1 diabetes (RR 1.72, 95%CI 1.05-2.80; p = 0.03), respiratory comorbidities/diseases (RR 1.32, 95%CI 1.02-1.70; p = 0.04), ischemic heart disease (IHD) (RR 1.20, 95%CI 1.01-1.43; p = 0.04) and α1-adrenergic receptor blockers use (RR 1.32, 95%CI 1.03-1.69; p = 0.03).</p><p><strong>Conclusions: </strong>These real-world data indicate considerable prevalence of OH in hypertensive inpatients and confirm the association between OH and several common comorbidities as well as with use of α1-adrenergic receptor blockers.</p><p><strong>Clinical trial registration: </strong>NCT05247060.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445854","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":"Hypertension Education, Provider, and Cardio-Cerebrovascular Symptom Awareness: 2024 Korea Community Health Survey.","authors":"Nayoung Kang, Youngjae Kim, Sangah Park, Youngjin Ryu, Sangeun Kim, Jihye Yoon, Sangeun Kim, Juyoung Park, Taegon Jang, Sungjin Cho, Chungah Kim","doi":"10.1007/s40292-026-00811-7","DOIUrl":"https://doi.org/10.1007/s40292-026-00811-7","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension, cardiovascular disease, and cerebrovascular disease are significant public health challenges worldwide. In South Korea, heart disease and cerebrovascular disease are among the leading causes of death, and hypertension prevalence remains substantial. While hypertension management education has been associated with improved disease knowledge and self-care behaviours, studies on the association educational effectiveness and provider type at the population level are limited.</p><p><strong>Aim: </strong>To examine the association between hypertension management education experience, education provider type, and knowledge of early cardio-cerebrovascular disease symptoms among adults with hypertension using nationally representative data.</p><p><strong>Methods: </strong>This cross-sectional secondary data analysis used the 2024 Korea Community Health Survey. The analytic sample comprised 71,859 adults aged 19 years or older with physician-diagnosed hypertension. Knowledge of early cardio-cerebrovascular symptoms was measured using a validated 10-item score. Multiple linear regression analyses were conducted to assess the association between education experience, education provider type, and knowledge scores, adjusting for sociodemographic, health status, and health behaviour covariates. Interaction and stratified analyses examined potential effect modification by sex, age, education level, and income.</p><p><strong>Results: </strong>Among the participants, 18.3% had received hypertension management education in the past year. After full covariate adjustment, the education group had significantly higher knowledge scores than the non-education group (β = 0.273, 95% CI 0.197-0.349). Education at public health centres or other community-based providers was associated with the largest score difference (β = 0.366, 95% CI 0.188-0.545), followed by clinics/hospitals (β = 0.259, 95% CI 0.176-0.342). Interaction analyses indicated that the magnitude of the association was significantly greater among women, older adults, those with lower education, and those with lower income.</p><p><strong>Conclusions: </strong>Hypertension management education was positively associated with higher knowledge of early cardio-cerebrovascular warning symptoms, with a particularly greater association among socioeconomically disadvantaged populations. These findings support the potential value of expanding structured education through both primary care and community-based public health programmes.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420634","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":"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":"397-409"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","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":"Lipoprotein(a) Does Not Correlate with Hypertensive Mediated Organ Damage and Subsequent Cardiovascular Events in a Primary Prevention Cohort.","authors":"Chiara Tognola, Davide Paolo Bernasconi, Paola Rebora, Rita Cristina Myriam Intravaia, Costantino Mancusi, Valeria Visco, Arturo Cesaro, Enrica Golia, Fucile Ilaria, Piera Merlini, Maddalena Ardissino, Elvira Inglese, Romano Danesi, Fabrizio Oliva, Anita Andreano, Magda Rognoni, Antonio Russo, Paolo Calabrò, Nicola De Luca, Cristina Giannattasio, Alessandro Maloberti","doi":"10.1007/s40292-026-00781-w","DOIUrl":"10.1007/s40292-026-00781-w","url":null,"abstract":"<p><strong>Introduction: </strong>Elevated lipoprotein(a) [Lp(a)] levels have been strongly related to cardiovascular (CV) risk. However, its association with Hypertension Mediated Organ Damage (HMOD) and CV events in the primary prevention setting remains unclear.</p><p><strong>Aim: </strong>To evaluate in these patients, the correlation between Lp(a) levels and: (i) heart, vessels and kidney HMOD and; (ii) CV events and all-cause mortality in a primary prevention setting.</p><p><strong>Methods: </strong>747 low CV risk subjects were recruited between 2009 and 2014. HMOD was assessed through Pulse Wave Velocity, carotid Intima-Media Thickness (IMT), presence of carotid plaques, Left Ventricular Hypertrophy (LVH) and Ejection Fraction and glomerular filtration rate. All-cause mortality and CV events up to 2021 were retrieved by electronic health records, for a median follow-up time of 10 years (I-III quartiles 9.6-11.1).</p><p><strong>Results: </strong>Mean age was 50.8 ± 13.0 years and 63.5% of the subjects were men. The prevalence of hypertension was 37.9%, dyslipidemia 67.2%, smoking 17.8%, and diabetes mellitus 8.7%. Median Lp(a) value was 17 mg/dL (5.9-56.0), and 26.5% of patients had values above 50 mg/dL. Regarding HMOD, 10.3% subjects had arterial stiffness, 7.2% increased IMT, 19.8% carotid plaques while only 0.7% had LVH. No significant correlation was found between Lp(a) levels and indices of subclinical HMOD. Furthermore, no relationship was found between CV events and all-cause mortality and Lp(a) levels.</p><p><strong>Conclusions: </strong>In this primary prevention cohort, elevated Lp(a) levels were not associated with significant structural damage to the heart, carotid arteries, or increased aortic stiffness and were not associated with CV events and all-cause mortality.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"425-437"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480280","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}