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Low-Dose Triple-Pill of Telmisartan, Amlodipine, and Indapamide for Initial Hypertension Treatment: A GRADE-Assessed Meta-analysis of Randomized Trials. 替米沙坦、氨氯地平和吲达帕胺低剂量三联片用于高血压初始治疗:一项随机试验的分级评估meta分析
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2026-01-01 Epub Date: 2025-11-12 DOI: 10.1007/s40292-025-00751-8
Abdalhakim Shubietah, Mohamed S Elgendy, Ahmed Emara, Hamza A Abdul-Hafez, Ameer Awashra, Ibrahim Elbably, Mohamed Abuelazm, Mohammed Mhanna
{"title":"Low-Dose Triple-Pill of Telmisartan, Amlodipine, and Indapamide for Initial Hypertension Treatment: A GRADE-Assessed Meta-analysis of Randomized Trials.","authors":"Abdalhakim Shubietah, Mohamed S Elgendy, Ahmed Emara, Hamza A Abdul-Hafez, Ameer Awashra, Ibrahim Elbably, Mohamed Abuelazm, Mohammed Mhanna","doi":"10.1007/s40292-025-00751-8","DOIUrl":"10.1007/s40292-025-00751-8","url":null,"abstract":"<p><strong>Introduction: </strong>FDA-approved GMRx2, a single-pill combination of telmisartan, amlodipine, and indapamide, has shown potential for improving blood pressure (BP) control.</p><p><strong>Aim: </strong>We assessed the efficacy and safety of low-dose GMRx2 compared to placebo, or standard-care (monotherapy or dual therapy) in mild to moderate hypertension.</p><p><strong>Methods: </strong>A meta-analysis of randomized controlled trials (RCTs) was conducted from PubMed, Embase, Cochrane, Scopus, and Web of Science from 2006 to June 2025. Random-effects model to pool mean difference (MD) for continuous outcomes and risk ratios (RR) for binary outcomes with 95% confidence intervals (CI).</p><p><strong>Prospero-id: </strong>CRD420251108645 RESULTS: Four RCTs involving 1999 patients were included. Compared with control, low-dose GMRx2 significantly reduced office systolic BP at 4-6 weeks (MD -8.84 mmHg, 95% CI [-11.27; -6.46]) and 12 weeks (MD -5.52 mmHg, 95% CI [-6.85; -4.18]). It also increased the proportion of patients achieving target office BP at 4-6 weeks (66.7% vs. 50.2%, RR 1.20, 95% CI [1.08-1.43]) and 8-12 weeks (75.6% vs. 59.5%, RR 1.15, 95% CI [1.05-1.26]). No significant differences were observed in serious adverse events (P= 0.77) or treatment discontinuation (P= 0.30). However, low-dose GMRx2 had a higher incidence of hypokalemia (9% vs. 7%, RR 1.40, 95% CI [1.04-1.90]) and hyponatremia (5% vs. 3.7%, RR 1.59, 95% CI [1.04-2.42]).</p><p><strong>Conclusion: </strong>Low-dose GMRx2 provides superior BP reduction and a well-tolerated safety profile in patients with mild to moderate hypertension. Nonetheless, it may increase the risk of hypokalemia and hyponatremia. Larger and longer-term RCTs are warranted to confirm.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"25-40"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495332","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}
引用次数: 0
Body Roundness Index Mediates the Association Between Triglyceride-Glucose Index and Hypertension: A Cross-Sectional Study. 身体圆度指数介导甘油三酯-葡萄糖指数与高血压之间的关系:一项横断面研究
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2026-01-01 Epub Date: 2025-11-12 DOI: 10.1007/s40292-025-00757-2
Jing Wang, Xingjie Huang, Zhexuan Deng, Song Wen, Xiaoyang Pei
{"title":"Body Roundness Index Mediates the Association Between Triglyceride-Glucose Index and Hypertension: A Cross-Sectional Study.","authors":"Jing Wang, Xingjie Huang, Zhexuan Deng, Song Wen, Xiaoyang Pei","doi":"10.1007/s40292-025-00757-2","DOIUrl":"10.1007/s40292-025-00757-2","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have shown a correlation between the triglyceride glucose index (TyG) and hypertension, as well as between body roundness index (BRI) and hypertension. However, there is limited research on the bidirectional mediation effects of TyG and BRI on their relationships with hypertension.</p><p><strong>Aim: </strong>We aimed to assess the associations between the TyG with hypertension among participants with different BRI, and examine the potential mediating effect of BRI on the associations between TyG with hypertension.</p><p><strong>Methods: </strong>This cross-sectional study involved 9,251 middle-aged and elderly individuals from the China Health and Retirement Longitudinal Study. Association between TyG and BRI, and hypertension was examined using multivariable logistic regression, restricted cubic spline analysis, and subgroup analysis. Bidirectional mediation analysis was conducted to determine the direct and indirect effects through BRI and TyG.</p><p><strong>Results: </strong>After adjusting for potential confounders, TyG was associated with a 40% (OR: 1.40; 95% CI: 1.23-1.59) higher risk for hypertension, and BRI was associated with a 33% (OR: 1.33; 95% CI: 1.28-1.38) higher risk for hypertension. A linear association between TyG and hypertension was noted (P<sub>overall</sub><0.0001, P<sub>non-linearity</sub>=0.173), and there was a nonlinear relationship between BRI and hypertension (P<sub>overall</sub><0.0001, P<sub>non-linearity</sub><0.0001). BRI was found to mediate 11.71%, 11.66%, and 11.76% of the associations between TyG and hypertension, SBP, and DBP. No significant multiplicative and additive interactions were found between TyG and BRI on hypertension (Additive: RERI = 1.25, 95% CI: -8.03-14.17; Multiplicative: OR = 0.90, 95% CI: 0.77-1.04).</p><p><strong>Conclusions: </strong>BRI appeared to be associated with hypertension risk and played a mediating role in the association between TyG and hypertension. Managing visceral fat and monitoring TyG levels may contribute to alleviating hypertension.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"93-104"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495320","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}
引用次数: 0
Rationale for the Use of Fixed Combination Therapies with Angiotensin Converting Enzyme Inhibitors and Beta-Blockers in Patients with Essential Hypertension and High Cardiovascular Risk: A Consensus Document from the Italian Society of Arterial Hypertension (Siia) and the Italian Society of Cardiovascular Prevention (SIPREC). 血管紧张素转换酶抑制剂和β受体阻滞剂联合治疗原发性高血压和心血管高危患者的基本原理:意大利动脉高血压学会(Siia)和意大利心血管预防学会(SIPREC)的共识文件。
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2026-01-01 Epub Date: 2025-11-21 DOI: 10.1007/s40292-025-00761-6
Agostino Virdis, Giuliano Tocci, Maria Lorenza Muiesan, GiovamBattista Desideri, Francesca Viazzi, Fabio Lucio Albini, Riccardo Sarzani, Gallo Giovanna, Guido Grassi, Massimo Volpe
{"title":"Rationale for the Use of Fixed Combination Therapies with Angiotensin Converting Enzyme Inhibitors and Beta-Blockers in Patients with Essential Hypertension and High Cardiovascular Risk: A Consensus Document from the Italian Society of Arterial Hypertension (Siia) and the Italian Society of Cardiovascular Prevention (SIPREC).","authors":"Agostino Virdis, Giuliano Tocci, Maria Lorenza Muiesan, GiovamBattista Desideri, Francesca Viazzi, Fabio Lucio Albini, Riccardo Sarzani, Gallo Giovanna, Guido Grassi, Massimo Volpe","doi":"10.1007/s40292-025-00761-6","DOIUrl":"10.1007/s40292-025-00761-6","url":null,"abstract":"<p><p>Essential hypertension represents the main risk factor for coronary events, including acute myocardial infarction, coronary syndromes, and unstable angina, as well as for chronic coronary artery disease (CAD). It also increases the risk of peripheral artery disease and chronic kidney disease, thus contributing to worsen prognosis, deteriorating quality of life, favouring unplanned hospitalizations due to cardiovascular (CV) causes, and affecting elevated costs for health care systems. Moreover, hypertension may contribute to development and progression of left ventricular (LV) remodelling and dysfunction, which may, in turn, promote the onset of cardiac arrhythmias, mostly atrial fibrillation (AF), and congestive heart failure with preserved ejection fraction (HFpEF). All these clinical conditions related to hypertension can be included in the definition of high or very high CV risk profile. Lowering blood pressure (BP) levels to the recommended therapeutic targets is a mandatory step for reducing the burden of hypertension-related CV complications, as well as for improving quality of life and event-free survival in patients with hypertension at high or very high CV risk. Current guidelines recommend the use of combination therapies, possibly in fixed formulations, even as first-line therapy, in almost all patients with hypertension, including those at high or very risk CV risk profile. Such combination therapies have proven to lower BP, reduce CV morbidity and mortality, as well as the risk of hospitalization due to CV causes. In particular, combination therapies based on the use of an angiotensin-converting enzyme (ACE) inhibitor plus a beta-blocker (BB) have demonstrated to be effective in lowering BP and heart rate, promoting reverse cardiac and vascular remodelling, and reducing CV morbidity and mortality in patients with hypertension and chronic CAD, cardiac arrhythmias, or HFpEF. This consensus document, endorsed by the Italian Society of Hypertension (SIIA) and the Italian Society for Cardiovascular Prevention (SIPREC), will discuss the available evidence and clinical indications supporting the use of fixed combination therapies based on ACE inhibitors plus BBs in patients with hypertension and high or very high CV risk profile, including those with chronic CAD, cardiac arrhythmias, or HFpEF.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"13-23"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563698","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}
引用次数: 0
Dapagliflozin Reduces Ambulatory Arterial Stiffness Index in CKD Patients with and Without Diabetes Independently of Blood Pressure Control: Results from the GLUcose Transport and Renal PROtection in Chronic Kidney Disease (GLUTREPRO) Trial. 达格列净在独立于血压控制的情况下降低伴有和不伴有糖尿病的CKD患者的动态动脉僵硬指数:来自慢性肾脏疾病中葡萄糖转运和肾脏保护(GLUTREPRO)试验的结果
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2026-01-01 Epub Date: 2025-12-09 DOI: 10.1007/s40292-025-00764-3
Elisa Russo, Francesca Cappadona, Lucia Macciò, Julie Di Vincenzo, Michela Piaggio, Daniela Verzola, Giuseppe Chirco, Giacomo Garibotto, Pasquale Esposito, Francesca Viazzi
{"title":"Dapagliflozin Reduces Ambulatory Arterial Stiffness Index in CKD Patients with and Without Diabetes Independently of Blood Pressure Control: Results from the GLUcose Transport and Renal PROtection in Chronic Kidney Disease (GLUTREPRO) Trial.","authors":"Elisa Russo, Francesca Cappadona, Lucia Macciò, Julie Di Vincenzo, Michela Piaggio, Daniela Verzola, Giuseppe Chirco, Giacomo Garibotto, Pasquale Esposito, Francesca Viazzi","doi":"10.1007/s40292-025-00764-3","DOIUrl":"10.1007/s40292-025-00764-3","url":null,"abstract":"<p><strong>Introduction: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) confer cardiovascular and renal protection, but their impact on blood pressure (BP) and vascular stiffness in chronic kidney disease (CKD) is not fully defined.</p><p><strong>Aim: </strong>To investigate the effect of dapagliflozin on 24h-BP behavior and ambulatory arterial stiffness index (AASI) as a predefined secondary outcome of the GLUTREPRO trial.</p><p><strong>Methods: </strong>In this randomized trial, 32 patients with albuminuric CKD received dapagliflozin 10 mg/day or placebo on top of optimized standard therapy. Laboratory tests, ambulatory blood pressure monitoring (ABPM), and bioimpedance were performed at baseline and during follow-up. The study comprised a 6-month randomized phase and a 12-month open-label phase, analyzed with mixed-effects models.</p><p><strong>Results: </strong>Baseline characteristics were balanced (mean age 58 ± 14 years, 37% diabetes, eGFR 50.6 ± 17.3 ml/min/1.73 m<sup>2</sup>, UACR 582 ± 893 mg/g). Dapagliflozin induced an early eGFR dip (-3 to -6 ml/min/1.73m<sup>2</sup>) followed by stabilization. Overall, UACR did not change significantly, but patients with baseline microalbuminuria showed lower UACR after six months versus placebo. ABPM revealed no significant differences in BP or dipping status. Conversely, dapagliflozin significantly reduced AASI at 6 months (0.50 vs. 0.62; p = 0.04), with a trend toward sustained improvement thereafter. Multivariable regression identified dapagliflozin as an independent predictor of lower AASI (β = - 0.067; 95% CI -0.130 to -0.002; p = 0.043), independent of diabetes, 24-h Systolic BP, heart rate, kidney function, fractional sodium excretion, and TyG index.</p><p><strong>Conclusion: </strong>In patients with albuminuric CKD, dapagliflozin lowered AASI independently of BP control and sodium handling, suggesting favorable vascular remodeling in both diabetic and non-diabetic patients.</p><p><strong>Trial registration: </strong>The study was registered in the EU Clinical Trials Register (EudraCT: 2020-004835-26) and online at the https://www.</p><p><strong>Clinicaltrials: </strong>gov (Unique identifier: NCT05998837, 13th April 2021).</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"117-126"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714031","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}
引用次数: 0
Obituary Prof. Speranza Donatella Rubattu. 希望多纳泰拉·鲁巴图教授。
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2025-12-09 DOI: 10.1007/s40292-025-00774-1
Massimo Volpe
{"title":"Obituary Prof. Speranza Donatella Rubattu.","authors":"Massimo Volpe","doi":"10.1007/s40292-025-00774-1","DOIUrl":"https://doi.org/10.1007/s40292-025-00774-1","url":null,"abstract":"","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714080","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}
引用次数: 0
2025 National Congress of the Italian Society of Hypertension. 2025年意大利高血压学会全国代表大会。
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2025-11-01 DOI: 10.1007/s40292-025-00752-7
{"title":"2025 National Congress of the Italian Society of Hypertension.","authors":"","doi":"10.1007/s40292-025-00752-7","DOIUrl":"10.1007/s40292-025-00752-7","url":null,"abstract":"","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"709-774"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563777","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}
引用次数: 0
Pulse Wave Velocity Progression Determinants: No Significant Association with Novel Lipids Parameter. 脉搏波速度进展决定因素:与新型脂质参数无显著关联。
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2025-11-01 Epub Date: 2025-09-22 DOI: 10.1007/s40292-025-00741-w
Ilaria Garofani, Chiara Tognola, Martina Morelli, Atea Shkodra, Michela Algeri, Marco Bellomare, Valentina Colombo, Filippo Brucato, Serena Guasti, Andrea Bonelli, Cristina Giannattasio, Alessandro Maloberti
{"title":"Pulse Wave Velocity Progression Determinants: No Significant Association with Novel Lipids Parameter.","authors":"Ilaria Garofani, Chiara Tognola, Martina Morelli, Atea Shkodra, Michela Algeri, Marco Bellomare, Valentina Colombo, Filippo Brucato, Serena Guasti, Andrea Bonelli, Cristina Giannattasio, Alessandro Maloberti","doi":"10.1007/s40292-025-00741-w","DOIUrl":"10.1007/s40292-025-00741-w","url":null,"abstract":"<p><strong>Introduction: </strong>Whether novel lipid parameters are related to arterial stiffness (pulse wave velocity-PWV), changes during follow-up (i.e ΔPWV) has never been evaluated.</p><p><strong>Aim: </strong>To evaluate the relationship between standard and emerging lipid parameters (non-HDL/HDL, LDL/HDL, total cholesterol/HDL, TG/HDL, Log(TG)/HDL, Log(TG/HDL) and the triglyceride-glucose index [TyG]) and ΔPWV among hypertensive patients.</p><p><strong>Methods: </strong>We included 469 hypertensive patients enrolled from September 2006 to October 2010 from the Hypertension Unit of San Gerardo Hospital (Monza, Italy). PWV was measured at baseline and after a mean follow-up of 3.8 years (I-III quartiles 3.5-4.2 years) and the relative change (ΔPWV) was calculated.</p><p><strong>Results: </strong>The study cohort had a mean age of 53.6 ± 12.9 years and 58.4% were male. PWV significantly increased from baseline to follow-up (8.6 ± 2.1 vs. 9.2 ± 2.4 m/s; p=0.0001), with 51.6% of patients exhibiting a ΔPWV≥0.5 m/s. These patients had a significantly lower HDL cholesterol (51.5 ± 13.5 vs. 54.7 ± 13.3 mg/dL) with higher LDL/HDL ratio (2.5 ± 0.9 vs. 2.3 ± 0.9 p=0.049), non-HDL/HDL ratio (3.0 ± 1.1 vs. 2.8 ± 1.1), total cholesterol/HDL ratio (4.0 ± 1.1 vs. 3.8 ± 1.1), Log(TG)/HDL (0.043 ± 0.015 vs. 0.039 ± 0.014) and Log(TG/HDL) (0.351 ± 0.290 vs. 0.295 ± 0.278, p<0.05 for all comparison). A significant univariate association was found between ΔPWV and ΔPWV≥0.5 and Log(TG)/HDL (r = 0.121, p =  0.009 and r = 0.094, p =  0.042, respectively) but it didn't persist at multivariable analysis adjusted for age, sex, Δ systolic blood pressure, anti-hypertensive therapies and statins, diabetes, and glomerular filtration rate.</p><p><strong>Conclusions: </strong>Our study found no significant associations between emerging lipid parameters and PWV/ΔPWV. Age and blood pressure values remains the main determinants of PWV and its changes over time.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"645-655"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12647226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113001","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}
引用次数: 0
Efficacy and Safety of Lorundrostat in Uncontrolled and/or Treatment Resistant Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Lorundrostat治疗未控制和/或难治性高血压的疗效和安全性:随机对照试验的系统评价和荟萃分析
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2025-11-01 Epub Date: 2025-10-17 DOI: 10.1007/s40292-025-00742-9
Manahil Mubeen, Kuldeep Dalpat Rai, Aneesh Kumar Sangtiani, Laiba Shuaib, Ayesha Irfan, Sijan Poudel
{"title":"Efficacy and Safety of Lorundrostat in Uncontrolled and/or Treatment Resistant Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Manahil Mubeen, Kuldeep Dalpat Rai, Aneesh Kumar Sangtiani, Laiba Shuaib, Ayesha Irfan, Sijan Poudel","doi":"10.1007/s40292-025-00742-9","DOIUrl":"10.1007/s40292-025-00742-9","url":null,"abstract":"<p><strong>Background: </strong>Resistant hypertension (RH) persists despite use of three different antihypertensive drug classes. Additionally, people with persistent hypertension despite the use of multiple drugs, who do not fit the RH criteria are said to have uncontrolled hypertension. Both these populations have increased risk of cardiovascular, CNS, and renal complications. Aldosterone plays a key role in RH and uncontrolled hypertension. Lorundrostat, a selective aldosterone synthase inhibitor targeting CYP11B2 enzyme, shows promise in improving blood pressure control in these populations.</p><p><strong>Aim: </strong>To evaluate lorundrostat's efficacy and safety in uncontrolled and treatment-resistant hypertension through a meta-analysis of randomized controlled trials.</p><p><strong>Methods: </strong>We searched PubMed, Cochrane, Google Scholar, and clinicaltrials.gov through July 2025. Screening was done via rayyan.ai; data analyzed with Review Manager 5.4. Risk of bias and evidence certainty used Cochrane Risk of Bias 2.0 and GRADE.</p><p><strong>Results: </strong>Three high-quality RCTs with 1426 patients were included. Stable dose lorundrostat significantly reduced mean systolic blood pressure compared to placebo (MD = - 9.81 mmHg; 95% CI [- 12.80, - 6.83]; p < 0.00001) and dose-adjusted lorundrostat also showed reduction (MD= - 7.35; 95% CI [- 10.81, - 3.89]; p < 0.0001). Adverse events; hypotension, hyponatremia, hyperkalemia, and reduced GFR were more frequent with lorundrostat, while hypertension-related events were more common in placebo. Certainty of evidence was high (except for any adverse event), and heterogeneity was low across outcomes (except for any adverse event with dose adjustment).</p><p><strong>Conclusion: </strong>Lorundrostat effectively reduces systolic BP in uncontrolled and resistant hypertension but requires cautious monitoring due to safety concerns.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"599-615"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312728","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}
引用次数: 0
Isolated Morning Hypertension is a Predictor of Cardiovascular Events in Treated and Well Controlled Hypertensive Patients. 孤立的早晨高血压是治疗和控制良好的高血压患者心血管事件的预测因子。
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2025-11-01 Epub Date: 2025-10-13 DOI: 10.1007/s40292-025-00746-5
Romina Diaz, Jessica Barochiner, Lucas Aparicio, Rocio Martinez
{"title":"Isolated Morning Hypertension is a Predictor of Cardiovascular Events in Treated and Well Controlled Hypertensive Patients.","authors":"Romina Diaz, Jessica Barochiner, Lucas Aparicio, Rocio Martinez","doi":"10.1007/s40292-025-00746-5","DOIUrl":"10.1007/s40292-025-00746-5","url":null,"abstract":"<p><strong>Introduction: </strong>The prognostic significance of isolated morning hypertension (IMH) in treated hypertensive patients remains unclear. Although overall blood pressure (BP) control is often considered adequate, morning BP surges may still pose cardiovascular risks.</p><p><strong>Aim: </strong>To determine whether the presence of IMH in treated hypertensive patients with globally controlled BP is associated with an increased risk of cardiovascular events.</p><p><strong>Methods: </strong>This cohort study included hypertensive patients on stable antihypertensive treatment for ≥ 4 weeks who underwent home blood pressure monitoring (HBPM) between September 1, 2008, and December 31, 2015. BP was measured in duplicate over four days (morning, afternoon, and evening) using an OMRON 705 CP device. IMH was defined as an average morning BP > 135 and/or 85 mmHg, despite overall mean BP < 135/85 mmHg. Patients were followed until April 30, 2020, for fatal and non-fatal cardiovascular and cerebrovascular events. Cox proportional hazards models were used to assess the prognostic value of IMH.</p><p><strong>Results: </strong>A total of 925 patients were included, with a prevalence of IMH of 17.4% (95% CI 15.1-20%). During a median follow-up of 6.2 years, 126 cardiovascular events occurred. Compared to well-controlled hypertensive patients without IMH, those with IMH had a significantly higher risk of cardiovascular events after adjusting for sex, age, body mass index, number of antihypertensive drugs, smoking status, diabetes, and office BP (HR 1.6, 95% CI 1.1-2.2; p = 0.02).</p><p><strong>Conclusions: </strong>IMH detected through HBPM was associated with an increased risk of fatal and non-fatal cardiovascular and cerebrovascular events in treated hypertensive patients with otherwise adequate global BP control. Monitoring and addressing IMH may be essential to further reducing cardiovascular risk.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"687-695"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280087","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}
引用次数: 0
Hypertension International Guidelines: Three of a Kind? 高血压国际指南:三种?
IF 2.9
High Blood Pressure & Cardiovascular Prevention Pub Date : 2025-11-01 Epub Date: 2025-10-13 DOI: 10.1007/s40292-025-00748-3
Agostino Virdis, Maria Lorenza Muiesan, Guido Grassi, Massimo Volpe
{"title":"Hypertension International Guidelines: Three of a Kind?","authors":"Agostino Virdis, Maria Lorenza Muiesan, Guido Grassi, Massimo Volpe","doi":"10.1007/s40292-025-00748-3","DOIUrl":"10.1007/s40292-025-00748-3","url":null,"abstract":"","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"591-598"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280086","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}
引用次数: 0
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