Hypertension Research最新文献

{"title":"Self-measurement of blood pressure at home using a cuff device for change in blood pressure levels: systematic review and meta-analysis.","authors":"Michihiro Satoh, Yukako Tatsumi, Shingo Nakayama, Yukiko Shinohara, Miki Kawazoe, Yoichi Nozato, Ayako Kunimura, Takahisa Murakami, Maya Toyama, Tomoko Muroya, Takahito Yagihashi, Atsushi Sakima, Makiko Abe, Hisatomi Arima, Takayoshi Ohkubo","doi":"10.1038/s41440-024-01981-4","DOIUrl":"https://doi.org/10.1038/s41440-024-01981-4","url":null,"abstract":"<p><p>The effect of self-measurement of blood pressure (BP) at home (home BP measurement, HBPM) has been evaluated over the past decade. This meta-analysis included the latest studies to determine whether HBPM reduced BP (PROSPERO ID: CRD42023442225). PubMed, Cochrane Library Database, and IchuShi-Web were searched for randomized controlled trials after the year 2000 which demonstrated the effect of HBPM on BP change compared with usual care (UC). Overall, 65 articles (n = 21,053; 63 based on patients with hypertension) were included. The systolic/diastolic BP reduction was significantly greater in the HBPM than in the UC group by 3.27/1.61 mmHg (95% confidence intervals: 2.40-4.15/1.14-2.07) at the end of the intervention, and I² values ≥ 46.7% suggested moderate-to-high heterogeneity. The funnel plots exhibited no notable publication bias (Egger's test p ≥ 0.16). HBPM with co-interventions (such as telemonitoring) showed a stronger BP-lowering effect than without co-interventions while the effect of HBPM on BP change remained significant in the absence of co-interventions. HBPM was not associated with systolic BP changes when we combined the four studies that used a wrist cuff device for HBPM. The number of antihypertensive medications increased by 0.17 medications in the HBPM group compared with that in the UC group. There were no significant differences in body mass index changes or risk of severe adverse outcomes between the groups. Our results demonstrated a beneficial effect of HBPM in reducing BP, particularly when used in conjunction with telemonitoring or additional medical support and when employing upper-arm cuff devices.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686802","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":"Antihypertensive combinations: mind the potassium.","authors":"Shigeru Shibata","doi":"10.1038/s41440-024-01986-z","DOIUrl":"10.1038/s41440-024-01986-z","url":null,"abstract":"<p><p>Antihypertensive medications that can affect potassium homeostasis in the body. JGA, juxtaglomerular apparatus; ACEIs, angiotensin converting enzyme inhibitors; ARBs, angiotensin receptor blockers; MR, mineralocorticoid receptor.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619232","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":"Prognosis of apparent treatment-resistant hypertension and poor adherence: a nationwide cohort study.","authors":"Chan Joo Lee, Hokyou Lee, Jiwon Seo, Jinseub Hwang, Dayoung Kang, Soo-Hyun Park, Jin-Taek Hwang, Jae Ho Park, Sungha Park","doi":"10.1038/s41440-024-01988-x","DOIUrl":"https://doi.org/10.1038/s41440-024-01988-x","url":null,"abstract":"<p><p>Large-scale studies of the prognosis of resistant hypertension in Asian populations are limited, and the impact of poor adherence on clinical prognosis in patients with apparent treatment-resistant hypertension has not been studied. A nationwide cohort analysis was done utilizing the National Health Insurance Service database in Korea, covering patients who participated in health examinations from 2013 to 2018. A total of 935,002 patients were classified into apparent treatment-resistant (N = 69,372) or nonresistant (N = 865,630) hypertension based on blood pressure control and antihypertensive medication use. Medication adherence was assessed using the proportion of days covered. The primary composite outcome included all-cause mortality, myocardial infarction, stroke, and heart failure. Other outcomes were the development of atrial fibrillation and progression to end-stage renal disease (ESRD). The median follow-up duration was 6.0 (interquartile range [IQR], 4.1-7.0) years. Patients with apparent treatment-resistant hypertension were at a higher risk for the primary composite outcome than those with nonresistant hypertension (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.29-1.35). The incidence rates of ESRD were notably higher in the resistant hypertension group (HR, 3.02; 95% CI, 2.85-3.20). Among participants with resistant hypertension, 3852 (5.7%), 11,667 (17.3%), and 51,879 (77%) had poor, suboptimal, and optimal adherence, respectively. Poor medication adherence in apparent treatment-resistant hypertension was associated with a higher risk of the primary composite outcome compared to optimal adherence (HR, 1.49; 95% CI, 1.36-1.63). Apparent treatment-resistant hypertension is associated with significant cardiovascular risks in the Korean population. Poor adherence to antihypertensive medication significantly elevates the risk of adverse clinical outcomes in patients with apparent treatment-resistant hypertension, underscoring the need for stringent management of these patients.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619189","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":"Novel approaches to define responders to interventional treatment in hypertension: insights from the SPYRAL HTN-OFF and HTN-ON MED trials.","authors":"Roland E Schmieder, Douglas A Hettrick, Michael Böhm, David E Kandzari, Kazuomi Kario, Felix Mahfoud, Konstantinos Tsioufis, Michael A Weber, Murray D Esler, Raymond R Townsend","doi":"10.1038/s41440-024-01949-4","DOIUrl":"10.1038/s41440-024-01949-4","url":null,"abstract":"<p><p>Multiple sham-controlled clinical trials have demonstrated significant reductions in both office and 24-h blood pressure (BP) following radiofrequency renal denervation (RDN) in the uncontrolled hypertension population. Notably, the blood pressure response varies widely within individual participants, thus showing a clinical need to identify potential RDN \"responders\" prior to the procedure. Despite multiple analytic efforts, no single parameter, aside from baseline blood pressure, has been consistently associated with BP reduction following RDN. However, this failure may be due to limitations in empiric definitions of responders. Indeed, commonly applied responder definitions based on the difference between two point-in-time BP measurements are fraught due to visit-to-visit variability in office and 24-h blood pressure endpoints. Several factors should be considered to develop a more clinically useful operational definition of procedural response including relative changes in office and 24-h BP, consideration of the temporal response to RDN, as well as adjustment for baseline BP. The current evidence may provide incentives for future expert consensus to precisely define responders to hypertension treatments.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619188","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":"The interplay between cancer and cardiovascular disease.","authors":"Masanari Kuwabara","doi":"10.1038/s41440-024-02015-9","DOIUrl":"https://doi.org/10.1038/s41440-024-02015-9","url":null,"abstract":"<p><p>Cancer and cardiovascular disease (CVD) are the leading causes of death in Japan, with an increasingly recognized interrelationship. Both diseases share numerous risk factors and pathophysiological mechanisms, suggesting a bidirectional influence on onset and progression. Recent studies reveal that cancer survivors face elevated CVD risks, particularly shortly after diagnosis, while CVD may predispose individuals to cancer. Cancer treatments, including chemotherapy, can lead to cardiotoxicity and increased CVD complications. A study by Suzuki et al. demonstrates that individuals with hypertension and a history of cancer, especially those treated with chemotherapy, have a higher risk of developing CVD events. Despite limitations in study design and data specificity, these findings highlight the importance of long-term cardiovascular monitoring in cancer survivors. As cardio-oncology evolves, developing evidence-based guidelines and fostering collaboration between oncologists and cardiologists is crucial for optimizing patient care and outcomes in both cancer and CVD management.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619249","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":"Discrepancies between home blood pressure and ambulatory blood pressure monitoring in apparent treatment-resistant hypertension: analysis from the Korean resistant hypertension cohort.","authors":"Jiwon Seo, Chan Joo Lee, Dae-Hee Kim, Song-Yi Kim, Jae Youn Moon, Jae-Hyeong Park, Jang-Won Son, Jang Young Kim, In-Cheol Kim, Moo-Yong Rhee, Ju-Hee Lee, Hae-Young Lee, Joong-Wha Chung, Sang-Hyun Ihm, Jung Hyun Choi, Jinho Shin, Sungha Park","doi":"10.1038/s41440-024-02017-7","DOIUrl":"10.1038/s41440-024-02017-7","url":null,"abstract":"<p><p>This study aimed to investigate the characteristics of out-of-office blood pressure (BP) measurements in patients with apparent treatment-resistant hypertension (aRH) enrolled from 15 tertiary care centers in South Korea. aRH was defined as having uncontrolled office BP ≥ 130/80 mmHg despite receiving three classes of antihypertensive medication or any level of BP despite receiving ≥4 classes of antihypertensive medication. Patients with complete data for office BP, 24-h ambulatory BP monitoring (ABPM), and home BP measurements at baseline were included. BP control status between ABPM and home BP measurements was compared. Out of 1457 patients, 823 meeting the enrollment criteria were included (mean age: 59.9 ± 13.6 years; 57.5% male patients). Among them, 7.2% had controlled BP, 8.7% had whitecoat uncontrolled hypertension, 15.1% had masked uncontrolled hypertension, and 69% had sustained hypertension, as measured through baseline ABPM. Additionally, 43% of patients with controlled BP based on home BP measurement had nocturnal hypertension. Relying solely on home BP measurement may result in misclassifying 70% of patients as having either controlled BP or whitecoat uncontrolled BP. This study reaffirms the circadian pattern of resistant hypertension, characterized by a higher prevalence of non-dipping and rising patterns, even in patients with BP controlled based on ABPM. Considering the persistent difference between home BP measurement and ABPM, even at a lower home BP threshold, integrating both measurements into the management of aRH is advisable.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619177","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":"Maternal exercise represses FGF21 via SIRT1 to improve the phenotypic transformation of vascular smooth muscle in hypertensive offspring.","authors":"Meiling Shan, Fang Qiu, Peng Li, Yanyan Zhang, Lijun Shi","doi":"10.1038/s41440-024-01991-2","DOIUrl":"https://doi.org/10.1038/s41440-024-01991-2","url":null,"abstract":"<p><p>Maternal exercise during pregnancy is widely recognized as an effective means of promoting cardiovascular health in offspring. Few studies have explored how maternal exercise impacts vascular function and phenotypic switching in hypertensive offspring, despite the known involvement of vascular structural and functional remodeling in hypertension pathogenesis. Research indicates a significant relationship between elevated blood pressure and fibroblast growth factor 21 (FGF21) levels. It remains unclear whether maternal exercise during pregnancy can improve vascular function in hypertensive offspring by regulating FGF21 and its underlying mechanisms. In this study, pregnant spontaneously hypertensive rats and Wistar-Kyoto rats were randomly assigned to either a sedentary or exercise group. The exercise group underwent weightless swimming exercise from gestation day 1 (GD1) to GD20. The aim was to investigate the epigenetic modifications mediated by histone deacetylase sirtuin 1 (SIRT1) during the fetal period and the phenotypic changes in the mesenteric arteries (MAs) of hypertensive offspring. We found that maternal exercise significantly improved vascular remodeling in hypertensive offspring. Specifically, maternal exercise upregulated SIRT1 expression, which led to decreased H3K9ac (histone H3 lysine 9 acetylation) in the promoter region of the FGF21 gene. This epigenetic modification resulted in the transcriptional downregulation of FGF21 in the MAs of hypertensive fetuses. These results suggest that maternal exercise may lower blood pressure in hypertensive offspring by regulating deacetylation of the FGF21 gene promoter region through SIRT1, thereby reversing phenotypic switching and vascular structural remodeling.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619186","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":"Advances in digital technology in healthcare.","authors":"Toshiki Maeda","doi":"10.1038/s41440-024-02011-z","DOIUrl":"https://doi.org/10.1038/s41440-024-02011-z","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619230","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":"Serum uric acid is independently associated with impaired nitroglycerine-induced vasodilation of the brachial artery in women.","authors":"Tatsuya Maruhashi, Masato Kajikawa, Shinji Kishimoto, Takayuki Yamaji, Takahiro Harada, Aya Mizobuchi, Shunsuke Tanigawa, Farina Mohamad Yusoff, Yukiko Nakano, Kazuaki Chayama, Ayumu Nakashima, Chikara Goto, Yukihito Higashi","doi":"10.1038/s41440-024-01972-5","DOIUrl":"https://doi.org/10.1038/s41440-024-01972-5","url":null,"abstract":"<p><p>Experimental and clinical studies have suggested atherosclerotic effects of uric acid (UA) on vascular smooth muscle cells (VSMCs). Nitroglycerine-induced vasodilation (NID), a control test for flow-mediated vasodilation, can be used as a possible marker of VSMC dysfunction. However, there is little information on the association between UA and NID. Therefore, we investigated the association between serum UA levels and NID according to sex. We measured NID of the brachial artery in 598 women (mean age: 66.2 ± 12.0 years) and 1008 men (mean age: 59.0 ± 18.0 years). In women, the mean serum UA level was 5.06 ± 1.24 mg/dL. Serum UA levels were negatively correlated with NID (p < 0.001), and NID significantly decreased with increasing serum UA levels (≤4.0 mg/dL, 13.4 ± 6.4%; 4.0 to ≤5.0 mg/dL, 11.4 ± 5.3%; 5.0 to ≤6.0 mg/dL, 10.8 ± 5.7%; >6.0 mg/dL, 9.7 ± 5.7%; p < 0.001). The prevalence of VSMC dysfunction, defined as NID < 8.4%, the division points for the lowest and middle tertiles of NID in women, increased with increasing serum UA levels ( ≤ 4.0 mg/dL, 23.3%; 4.0 to ≤5.0 mg/dL, 30.9%; 5.0 to ≤6.0 mg/dL, 36.4%; >6.0 mg/dL, 44.6%; p < 0.001). Multiple logistic regression analysis showed a significant association between serum UA levels and VSMC dysfunction (odds ratio, 1.21; 95% confidence interval, 1.02─1.43; p = 0.03). There was no interaction between age (<50 or ≥50 years) and the effect of serum UA levels on VSMC dysfunction (p interaction = 0.88). In contrast, no association was observed between serum UA levels and NID in men. Serum UA levels were significantly associated with VSMC dysfunction as assessed by NID in women.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619245","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":"Nonsteroidal MR antagonism in PA: clinical outcomes and unanswered questions.","authors":"Daigoro Hirohama, Shigeru Shibata","doi":"10.1038/s41440-024-02002-0","DOIUrl":"https://doi.org/10.1038/s41440-024-02002-0","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619187","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}