Hypertension Research最新文献

{"title":"Long-term microvascular and blood pressure dysregulation after Preeclampsia.","authors":"Maya Jälmby, Camilla Edvinsson, Despoina Lykou, Grigorios Karampas, Lena Erlandsson, Stefan R Hansson, Federica Piani","doi":"10.1038/s41440-025-02176-1","DOIUrl":"https://doi.org/10.1038/s41440-025-02176-1","url":null,"abstract":"<p><p>Preeclampsia (PE) is a pregnancy disorder characterized by systemic endothelial damage that leads to long-term cardiovascular complications. The endothelial glycocalyx (EG) covers the luminal surface of endothelium playing a critical role in vascular homeostasis. In this study we aimed to evaluate EG thickness and blood pressure (BP) trends in women with a history of PE vs. normotensive pregnancy. Fifty-five women participated in the study (18 controls, 34 with PE, and 3 with gestational hypertension). Six years postpartum, we evaluated the sublingual microcirculation by sidestream dark-field microscopy, and assessed BP in the sitting and orthostatic position. At follow-up, women with PE had reduced EG thickness in vessels ≥ 8 µm, expressed by an increased perfused boundary region (PBR), compared to healthy controls (median 3.14 vs. 2.88 µm, p = 0.002). A trend towards increased red blood cell velocity in vessels ≥ 10 µm was also observed in PE vs. controls. The systolic and diastolic BP, as well as within-visit BP variability, were significantly higher in PE vs. controls. Adverse neonatal outcomes, umbilical artery Doppler and BP during both the pregnancy and the follow-up visit, were associated with maternal PBR value in vessels ≥ 8 µm. This study contributes to the existing literature on PE and the increased risk of future cardiovascular disease, highlighting the critical role of EG and BP regulatory mechanisms. Our results showed that the severity of hemodynamic and neonatal impairments during pregnancy may irreversibly affect the EG and thereby be associated with long-term maternal vascular dysfunction.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year nighttime blood pressure changes after radiofrequency renal denervation: pooled results from the SPYRAL HTN trials.","authors":"Kazuomi Kario, David E Kandzari, Felix Mahfoud, Michael A Weber, Roland E Schmieder, Konstantinos Tsioufis, Minglei Liu, Michael Böhm, Raymond R Townsend","doi":"10.1038/s41440-025-02186-z","DOIUrl":"https://doi.org/10.1038/s41440-025-02186-z","url":null,"abstract":"<p><p>Elevated nighttime blood pressure (BP) and abnormal circadian dipping patterns are associated with advanced age and coexisting illnesses and are attributed to autonomic dysfunction. Radiofrequency renal denervation (RF RDN) effectively lowers BP throughout 24 h and thus may provide an effective antihypertensive therapeutic option. This analysis assesses the effects of RDN on nocturnal hypertension with different dipper patterns defined by nighttime/daytime BP ratio (i.e. dippers, non-dippers, risers) through 2 years in patients randomized to RDN from the SPYRAL HTN-OFF MED and -ON MED trials. Office and 24-h ambulatory BP, were also evaluated in patients stratified by age, obstructive sleep apnea (OSA), type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). Among 388 patients, the baseline nighttime systolic BP (SBP) was 139.3 ± 11.3 mmHg. Patients with a riser pattern had the highest baseline nighttime SBP (152.7 ± 8.0 mmHg). At 2 years, patients experienced a significant reduction from baseline (p < 0.0001) in nighttime (-12.0 ± 17.1 mmHg), morning (-14.8 ± 20.0 mmHg), daytime (-13.8 ± 14.7 mmHg), and 24-h SBP (-13.4 ± 14.2 mmHg). The greatest reduction in SBP was in risers at nighttime (-23.7 ± 14.3 mmHg). RDN was equally effective in lowering nighttime BP in patients ≥65 years old or with OSA, CKD, or T2DM. In this pooled dataset of RF RDN patients, clinically meaningful reductions in BP over a 24-h period were observed through 2 years irrespective of dipping status. RF RDN may reduce the risk of cardiovascular outcomes in patients with uncontrolled hypertension, especially in those with elevated nighttime BP who may be the most challenging to treat.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-dialysis blood pressure: inaccuracy or lack of standardization?","authors":"Rodrigo Bezerra, Fernanda S Gorayeb-Polacchini, Flavio Teles, Luís Cláudio S Pinto, Wilson Nadruz","doi":"10.1038/s41440-025-02206-y","DOIUrl":"https://doi.org/10.1038/s41440-025-02206-y","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-dialytic blood pressure in hemodialysis patients: still an inaccurate metric.","authors":"Fotini Iatridi, Marieta P Theodorakopoulou, Pantelis Sarafidis","doi":"10.1038/s41440-025-02193-0","DOIUrl":"https://doi.org/10.1038/s41440-025-02193-0","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Personalised hypertension management with accurate blood pressure measurement: much achieved, much more to do.","authors":"James E Sharman","doi":"10.1038/s41440-025-02198-9","DOIUrl":"https://doi.org/10.1038/s41440-025-02198-9","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early onset of hypertension and increased relative risks of chronic kidney disease and mortality: two population-based cohort studies in United Kingdom and Hong Kong.","authors":"Kiki Sn Liu, Boyuan Wang, Ivy L Mak, Edmond Ph Choi, Cindy Lk Lam, Eric Yf Wan","doi":"10.1038/s41440-025-02188-x","DOIUrl":"10.1038/s41440-025-02188-x","url":null,"abstract":"<p><p>This study aimed to evaluate the association between hypertension (HT) onset age and later risks of chronic kidney diseases (CKD) and mortality. Adult patients without CKD from 2008 to 2013 were identified using electronic medical records from United Kingdom (UK) and Hong Kong (HK). Patients newly diagnosed with HT and those without were included in the HT and control groups, respectively. All subjects were stratified into six age groups (18-39, 40-49, 50-59, 60-69, 70-79, ≥80). Multivariable Cox proportional hazard regression, adjusted with baseline characteristics and fine stratification weights, was conducted to investigate the association between HT onset and risks of CKD, renal decline, end-stage renal disease (ESRD), and all-cause mortality. Subjects were followed up from baseline until an outcome event, death, or administrative end of the cohort, whichever occurred first. A total of 4,413,551 and 3,132,951 subjects were included in the UK and HK cohorts, respectively. HT was significantly associated with increased risks of outcome, but the hazard ratios (HRs) decreased with increasing onset age. In the UK cohort, the HRs (95% confidence intervals) for subjects aged 18-39 and ≥80 were 3.69 (3.53, 3.86) and 2.01 (1.96, 2.06) for CKD, 3.83 (3.60, 4.07) and 3.17 (2.97, 3.38) for renal decline, 17.26 (14.34, 20.77) and 2.55 (2.12, 3.07) for ESRD, 2.88 (2.66, 3.11) and 1.09 (1.07, 1.12) for mortality. The HK cohort exhibited a similar pattern. Our study concluded that early onset of HT significantly affects renal health later in life, while the contribution decreases with the onset age of HT.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure at hospital admission: a window into the prognoses of patients with atrial fibrillation.","authors":"Takahiro Okumura, Satoshi Yanagisawa, Toyoaki Murohara","doi":"10.1038/s41440-025-02196-x","DOIUrl":"https://doi.org/10.1038/s41440-025-02196-x","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microstructural damage and lower myelin content in the Brainstem associated with hypertension.","authors":"Joji Ishikawa","doi":"10.1038/s41440-025-02184-1","DOIUrl":"https://doi.org/10.1038/s41440-025-02184-1","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is lenvatinib-induced blood pressure elevation a favorable prognostic factor in patients with hepatocellular carcinoma?","authors":"Satoshi Kidoguchi","doi":"10.1038/s41440-025-02197-w","DOIUrl":"https://doi.org/10.1038/s41440-025-02197-w","url":null,"abstract":"<p><p>Lenvatinib, a multi-tyrosine kinase inhibitor approved for the treatment of multiple cancer types, can induce hypertension, which can be a prognostic indicator in patients with hepatocellular carcinoma. Further research into the mechanism of anticancer drug-induced blood pressure elevation is necessary and patients should be managed by a multi-disciplinary \"Onco-Hypertension\" team.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world use of finerenone in patients with chronic kidney disease and type 2 diabetes based on large-scale clinical studies: FIDELIO-DKD and FIGARO-DKD.","authors":"Atsuhisa Sato, Mitsuhiro Nishimoto","doi":"10.1038/s41440-025-02175-2","DOIUrl":"10.1038/s41440-025-02175-2","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Finerenone is a new mineralocorticoid receptor antagonist that does not have a steroid skeleton, and in two large-scale clinical studies targeting patients with chronic kidney disease (CKD) complicated with type 2 diabetes (FIDELIO-DKD and FIGARO-DKD), it significantly reduced the composite endpoints due to the progression of renal disease, and the composite endpoints of cardiovascular disease. Recently, we published two databases summarizing how finerenone is used in clinical practice in Japan (FINEROD). In this paper, we examines how best to use finerenone to get the most out of its effects. The most important side effect of finerenone is hyperkalemia, and the risk of hyperkalemia increases as renal function declines. By starting treatment early when eGFR is maintained, it is expected that side effects will be reduced. Furthermore, the FIDELITY analysis (a pooled analysis of FIDELIO-DKD and FIGARO-DKD) has shown that the clinical effect is stronger when finerenone treatment is started at an early stage of CKD. The simultaneous use of RAS inhibitors (ACE inhibitor or ARB), finerenone, and SGLT2 inhibitors appears to be a promising treatment. Further, it is important to continue the medications of RAS inhibitors and MR antagonists as long as possible. To prevent hyperkalemia, the most reliable and safest method is to use a new oral potassium adsorbent. It is important to think of a new oral potassium adsorbent not as something that will lower serum potassium levels, but as something that will allow you to avoid discontinuing or increase the dose of RAS inhibitors or MR antagonists. Differences between steroidal and non-steroidal mineralocorticoid receptor (MR) antagonists. Mineralocorticoid receptors (MR) are present in epithelial tissues such as renal tubules and intestinal epithelium, as well as in non-epithelial tissues such as the brain, heart, and blood vessel walls. Although the MR itself is exactly the same in both tissues, its physiological actions are completely different. In epithelial tissues, cortisol is inactivated by the enzyme 11β-hydroxysteroid dehydrogenase type 2 (11 β-HSD2), and aldosterone selectively binds to the MR. On the other hand, in non-epithelial tissues, 11 β-HSD2 is almost nonexistent or is only weakly active, so that cortisol, which outnumbers it, binds to almost all the MR, and aldosterone binds to the very few remaining MR. Spironolactone, a representative MR antagonist with a steroid skeleton, has a high affinity for renal tubules, and concentrates there, where it is highly effective. Therefore, it is classified as a potassium-sparing diuretic. However, if it does not have a steroid skeleton, its affinity for epithelial and non-epithelial tissues is equal. In other words, its effect on epithelial tissues is relatively weak, and its effect on non-epithelial tissues is relatively strong. Finerenone does not cross the blood-brain barrier (BBB), and does not reach the central nervous system. The central MR, esp","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}