Hypertension Research最新文献

{"title":"Mechanistic insights into the synergistic vasodilatory actions of eupatorin, sinensetin, and 3'-hydroxy-5,6,7,4'-tetramethoxyflavone in ex vivo aortic ring model and their antihypertensive efficacy in in vivo rat model.","authors":"Mun Fei Yam, Wan Yin Tew, Chu Shan Tan, Hui Wei Loh, Qiyue Qiu, Chong Seng Yan, Xiangyang Xu, Liyun Ouyang, Ruixian Zhou, Yau Pin Yap, Wei Xu, Wen Xu, Lai Kuan Teh","doi":"10.1038/s41440-025-02298-6","DOIUrl":"https://doi.org/10.1038/s41440-025-02298-6","url":null,"abstract":"<p><p>Orthosiphon stamineus Benth, commonly used in Southeast Asia for its medicinal properties, is traditionally employed to treat diabetes and hypertension. Scientific research has validated that O. stamineus extract exhibits significant vasodilatory action on rat aorta. This effect is primarily due to the synergistic interaction among key compounds: eupatorin, sinensetin and 3'-hydroxy-5,6,7,4'-tetramethoxyflavone (TMF). Our previous publication identified the optimum formulation, G28, which contains eupatorin, sinensetin and TMF in the ratio of EC₂₀:EC₁₅:EC₅. Therefore, the aim of this study was to investigate the antihypertensive effect and mechanism of action of formulation G28. In this study, aortic rings from spontaneously hypertensive rats (SHRs) and Sprague-Dawley (SD) rats were used to examine the vasodilation mechanisms. The antihypertensive effect of G28 was also assessed through repeated-dose administration in SHRs. G28 exhibited stronger vasorelaxant effects in SHR versus SD rat aortic rings, indicating higher potency under hypertensive conditions. The effect was partially endothelium-dependent, as endothelium removal reduced responses in both aortic rings. G28 retained efficacy with Nω-Nitro-1-arginine methyl ester, methylene blue and 1H-[1,2,4]Ox-adiazolol[4,3-α]quinoxaline-1-one, suggesting involvement of the NO/sGC/cGMP pathway. Additionally, G28's effect diminished with glibenclamide, barium chloride, 4-aminopyrine and tetraethylammonium, indicating potassium channel involvements. The vasorelaxant effect was not significantly altered by indomethacin, atropine, or propranolol (in SD rats only), suggesting independence from the cyclooxygenase, beta-adrenergic (in SD rats only) and muscarinic pathways. G28 also reduced intracellular Ca²⁺ in vascular smooth muscle by antagonising voltage-gated calcium channel and Inositol triphosphate receptor. In vivo, G28 significantly reduced blood pressure in SHRs over 21 days of oral administration, underscoring its potential for hypertension control. G28 shows strong antihypertensive effects via NO/sGC/cGMP, potassium and calcium channels. Its sustained blood pressure reduction in SHRs highlights potential as a promising hypertension treatment option.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086205","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":"Response to: \"Isolated diastolic hypertension: methodological and clinical considerations\".","authors":"Soroush Masrouri, Amirhossein Hasanpour, Danial Molavizadeh, Navid Ebrahimi, Fereidoun Azizi, Farzad Hadaegh","doi":"10.1038/s41440-025-02358-x","DOIUrl":"https://doi.org/10.1038/s41440-025-02358-x","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086179","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":"Longitudinal impact of weight change on blood pressure in University students.","authors":"Nobuko Yamada-Goto, Nahomi Sei, Ayano Murai-Takeda, Tatsuhiko Azegami, Keika Sakakibara-Adachi, Kaori Hayashi, Mikako Inokuchi, Hiroshi Hirose","doi":"10.1038/s41440-025-02370-1","DOIUrl":"https://doi.org/10.1038/s41440-025-02370-1","url":null,"abstract":"<p><p>Obesity-related hypertension is increasing in Japan, but limited evidence exists on how weight change in early adulthood affects blood pressure (BP). We aimed to investigate the longitudinal relationship between weight change and BP among Japanese university students. We analyzed data from 20,929 first-year students who underwent annual health checkups at Keio University from 2013 to 2016 and again three years later. Students were categorized into seven groups by percentage weight change. Associations between weight change and changes in systolic and diastolic BP (ΔSBP/ΔDBP) were examined using sex-stratified analyses and restricted cubic spline (RCS) models. Weight gain was linked to BP increases, while weight loss was associated with BP reductions. In men, weight gain >3% increased SBP and DBP, and weight loss >3% reduced SBP; DBP reduction was evident with >10% weight loss. In women, SBP increased with weight gain >5%, and DBP increased with >10% weight gain; SBP decreased with >10% weight loss. RCS models revealed nonlinear, dose-dependent associations with sex-specific patterns. Absolute BMI was also positively associated with BP, with inflection points consistently observed at BMI 21.6 kg/m² for SBP and DBP in women, and for DBP in men. Even moderate weight changes over three years significantly influenced BP, with SBP being more responsive than DBP and stronger effects observed in men. These findings suggest that even during shorter periods in young adults, body weight change has a high impact on BP and highlight the potential public health benefits of strategies aimed at preventing weight gain throughout adulthood. This study examined the longitudinal impact of weight change on blood pressure in university students in Japan. Weight gain increased ΔSBP and ΔDBP, while weight loss decreased them. Effects were stronger for SBP and more pronounced in men. Even during shorter periods in young adults, body weight change has a high impact on BP.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039939","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":"Socioeconomic inequalities and trends in self-reported hypertension and antihypertensive medication use in Australia between 2009 and 2021: a nationwide population-based cohort study.","authors":"Berhe W Sahle, Dianna J Magliano, Andre M N Renzaho, Christopher M Reid, Mark R Nelson, Sandra Nolte, Richard Ofori-Asenso","doi":"10.1038/s41440-025-02362-1","DOIUrl":"https://doi.org/10.1038/s41440-025-02362-1","url":null,"abstract":"<p><p>This study examined trends in the proportion of adults with self-reported hypertension and in antihypertensive medication use among community-dwelling Australian adults. We analysed data from a longitudinal panel study, covering four waves: 2009 (n = 8023), 2013 (n = 11,475), 2017 (n = 12,843), and 2021 (n = 14,571) for adults aged 18-74 years. Hypertension and antihypertensive medication use were self-reported. Healthcare subsidy was defined as the possession of a low-income healthcare card, a Pensioner Concession Card, or a Commonwealth Seniors Health Card. Prevalence estimates were age-standardised to the 2016 Australian Census population. The age-standardised prevalence of hypertension remained stable from 2009 to 2021, i.e., 15.7% (95% confidence interval [CI]: 15.1-16.4) in 2009 versus 15.2% (95% CI: 14.6-15.7) in 2021. Antihypertensive medication use increased from 39.4% (95% CI: 37.0-41.7) in 2009 to 46.7% (95% CI: 44.0-49.3) in 2021 (P_{for trend}: 0.017). The adjusted prevalence ratios (PR) for hypertension were 1.17 (95% CI: 1.11-1.21) in the 1st (most disadvantaged) Socio-Economic Indexes for Areas (SEIFA) quintiles, compared with the 5th (most advantaged) quintile. The PR for antihypertensive medication use were 1.63 (95% CI: 1.11-1.47) in the 1st quintile compared with the 5th quintile. About 58% to 78% of the increased prevalence of hypertension and antihypertensive medication use related to socioeconomic disadvantage was mediated by healthcare subsidy. The prevalence of hypertension in Australia remained stable between 2009 and 2021. While hypertension drug treatment rates improved over the same period, it remains very low, with less than half of those who reported hypertension receiving antihypertensive medication. Healthcare subsidies improve hypertension detection and treatment, especially in socioeconomically disadvantaged groups.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033235","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":"Smartphone application-based interventions for cardiometabolic risk factor management: A systematic review and meta-analysis.","authors":"Makiko Abe, Tetsuo Hirata, Natsumi Morito, Megumi Kawashima, Sumiko Yoshida, Yoichi Takami, Taku Fujimoto, Shin Kawasoe, Takeshi Shibukawa, Hiroyoshi Segawa, Toshitaka Yamanokuchi, Shintaro Ishida, Koji Takahashi, Kazuhiro Tada, Yoshifumi Kato, Atsushi Sakima, Hisatomi Arima","doi":"10.1038/s41440-025-02365-y","DOIUrl":"https://doi.org/10.1038/s41440-025-02365-y","url":null,"abstract":"<p><p>We previously conducted a systematic review and meta-analysis examining the effects of smartphone application-based interventions on blood pressure (BP). Building on that work, here we present a secondary analysis which explored the effects of these interventions on cardiometabolic risk factors. We searched MEDLINE, the Cochrane Library, and Ichushi for randomized controlled trials and observational studies comparing smartphone application-based interventions with usual care excluding digital technologies. Random-effects models were used to estimate pooled mean changes and 95% confidence intervals (CIs). A total of 76 studies involving 46459 participants were included. At 6-month follow-up, smartphone application-based interventions were significantly associated with reductions in fasting plasma glucose (-5.65 mg/dL, 95% CI: -10.12 to -1.19), body mass index (-0.58 kg/m², 95% CI: -0.80 to -0.36), waist circumference (-3.37 cm, 95% CI: -4.81 to -1.93), body weight (-1.60 kg, 95% CI: -2.30 to -0.90), low-density lipoprotein (LDL) cholesterol (-7.63 mg/dL, 95% CI: -11.64 to -3.62), total cholesterol (-9.01 mg/dL, 95% CI: -15.80 to -2.22), and triglycerides (-4.69 mg/dL, 95% CI: -8.69 to -0.70). These effects gradually declined by 12 months. BMI reduction showed a significant interaction with follow-up duration (p for interaction = 0.045). No significant differences in office BP reduction were observed across baseline BP levels. Notably, LDL cholesterol reduction was greater among East Asians than non-East Asians (p for interaction = 0.040). These findings highlight the potential of smartphone application-based interventions to improve cardiometabolic health and support self-management in adults.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992396","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":"Prognostic impact of excessive mitochondrial fission in patients with heart failure and evaluation of mitochondrial dynamics-related miRNAs in heart failure.","authors":"Akihiro Shirakabe, Yoshiyuki Ikeda, Yoshihiro Uchikado, Masato Matsushita, Tomofumi Sawatani, Shota Shigihara, Kenichi Tani, Masaki Morooka, Masahito Takahashi, Nobuaki Kobayashi, Mitsuru Ohishi, Junichi Sadoshima, Kuniya Asai","doi":"10.1038/s41440-025-02338-1","DOIUrl":"https://doi.org/10.1038/s41440-025-02338-1","url":null,"abstract":"<p><p>Mitochondria are dynamic organelles that can change their morphology. The role of these mitochondrial dynamics in cardiomyocytes remains obscure in patients with heart failure (HF). Endomyocardial biopsies were performed consecutively in 127 HF patients, and mitochondrial morphology data were obtained from 111 patients by electron microscopy. The patients were divided into three groups according to mitochondrial area quartiles (fission [Q1, area ≤ 0.119 μm², n = 27], normal [Q2/Q3, 0.120 μm² ≤ area ≤ 0.178 μm², n = 55], and fusion [Q4, area ≥ 0.179 μm², n = 28]). In the fission group, the serum N-terminal pro-brain natriuretic peptide and B-type natriuretic peptide (BNP) levels were significantly higher, and patients with HF and a reduced left ventricular ejection fraction were more common, than in the other groups. A multivariate logistic regression model showed that diabetes mellitus was independently associated with placement in the fission group (odds ratio: 2.835, 95%confidence interval [CI]: 1.037-7.752). A Kaplan-Meier curve analysis showed that the prognosis was significantly poorer in the fission group than in the other groups, and a multivariate Cox regression model revealed fission to be an independent predictor of 1500-day mortality (hazard ratio: 4.365, 95%CI: 1.198-15.909). The circulating levels of miR-140-5p (≥2500) were independently associated with the presence of mitochondrial fission (OR: 3.622, 95%CI: 1.260-10.413). Excessive mitochondrial fission was observed in patients with severe HF status, and was independently associated with adverse outcomes in HF patients. Circulating mitochondrial dynamics-related miRNA levels might be of use in detecting mitochondrial fission in the cardiomyocytes of HF patients.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992429","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":"Chinese Healthy Eating Index (CHEI) and risk of hypertension: A prospective cohort study in China.","authors":"Zhuangyu Zhang, Hongxia Li, Mengyang Xia, Zhiqiang Cao, Jingjing Li, Ling Liu, Yingying Ouyang, Chenrui Gong, Yuhan Tang, Ping Yao, Shuang Liu","doi":"10.1038/s41440-025-02369-8","DOIUrl":"https://doi.org/10.1038/s41440-025-02369-8","url":null,"abstract":"<p><p>The Chinese Healthy Eating Index (CHEI) is a valuable tool for assessing dietary quality. However, the relationship between CHEI and the risk of hypertension remains unclear. Therefore, a total of 1342 adults without hypertension at baseline and provided at least two survey data from 1997 to 2018 were included. Dietary information was collected by three consecutive 24-h recalls combined with household food inventory, and long-term diet quality was evaluated by the CHEI. Hypertension was defined as DBP ≥ 90 mmHg, SBP ≥ 140 mmHg, or using antihypertensive medication. Cox proportional hazard models were applied to estimate the hazard ratios (HRs) with 95% confidence intervals (CIs) of CHEI and new-onset hypertension. A total of 557 new hypertensive events were observed during 12851.5 person-years of follow-up. Compared with individuals in the first quartile of CHEI score, the HR of hypertension was 0.49 (95% CI: 0.38-0.63) in the fourth quartile. Restricted cubic spline analysis displayed an L-shaped non-linear association between CHEI score and hypertension risk. Increased intake of whole grains, fruits, dairy, soybeans, fish/seafood, and eggs, and decreased intake of red meat and sodium, were associated with lower risk of hypertension, with HRs (95% CIs) of whole grains (0.86, 0.78-0.95), fruits (0.70, 0.60-0.81), dairy (0.85, 0.75-0.96), soybeans (0.83, 0.75-0.92), fish/seafood (0.87, 0.79-0.95), eggs (0.87, 0.79-0.96), red meat (0.83, 0.74-0.93), and sodium (0.77, 0.69-0.85), respectively. In conclusion, higher dietary quality assessed by the CHEI was associated with a lower risk of hypertension, indicating that adhering to a healthy diet in accordance with DGC might be beneficial for preventing hypertension.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992379","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":"Goreisan attenuates cardiac hypertrophy and diastolic dysfunction in heart failure with preserved ejection fraction induced by HFD/L-NAME via regulation of ICAT-β-catenin/ERK axis.","authors":"Yoko Shojima Isayama, Shouji Matsushima, Keisuke Shinohara, Koichi Isayama, Nobuyuki Enzan, Taishi Yamamoto, Masashi Sada, Ryo Miyake, Yoshitomo Tsutsui, Takayuki Toyohara, Ryohei Nishimura, Yuki Ikeda, Eri Noda, Wataru Otsuru, Shuya Tokumoto, Masatsugu Watanabe, Masataka Ikeda, Toru Hashimoto, Shintaro Kinugawa, Hiroyuki Tsutsui, Kohtaro Abe","doi":"10.1038/s41440-025-02348-z","DOIUrl":"https://doi.org/10.1038/s41440-025-02348-z","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF), characterized by cardiac hypertrophy and diastolic dysfunction, is increasing worldwide. Goreisan (GRS) is a traditional herbal formulation; its component attenuates cardiomyocyte hypertrophy. This study aimed to investigate the effect of GRS on the pathophysiology of HFpEF. Administration of a high fat diet (HFD, 60% fat) and N-nitro-L-arginine methylester (L-NAME, 0.5 g/L in drinking water) increased heart and lung weights in C57BL/6 mice and GRS (5.9 mg/kcal) reduced them without changes in blood pressure. GRS attenuated HFD/L-NAME-induced increases in left ventricular wall thickness and E/A and E/E', indices of diastolic dysfunction. GRS decreased cardiomyocyte cross-sectional area in HFD/L-NAME-treated mice. Mechanistically, it suppressed the phosphorylation of mitogen-activated protein kinases (MAPKs), such as extracellular signal-regulated kinase (ERK), in HFD/L-NAME-treated hearts. In addition, liquid chromatography/mass spectrometry demonstrated that HFD/L-NAME decreased and GRS increased 73 proteins in the heart. Among them, GRS prevented HFD/L-NAME-induced decrease in inhibitor of β-catenin and T-cell factor (ICAT), a negative regulator of cardiac hypertrophy. Consistently, β-catenin, an ICAT target, exhibited the opposite change. In in vitro experiments, GRS directly decreased β-catenin in isoproterenol (ISO)-treated cardiomyocytes, accompanied by a decrease in cardiomyocyte surface area. Overexpression of ICAT also suppressed ISO-induced increases in β-catenin, phosphorylated ERK, and cardiomyocyte surface area. Among GRS ingredients, cinnamaldehyde and alisol B 23-acetate attenuated ISO-induced increases in β-catenin and cardiomyocyte surface area. In conclusion, GRS attenuates cardiac hypertrophy and diastolic dysfunction via ICAT-β-catenin/ERK axis. GRS is a potential herbal formulation for the treatment of HFpEF.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992410","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":"Current status of the use of validated home blood pressure monitoring devices among Korean patients with hypertension.","authors":"Jieun Lee, Yu-Mi Kim, Seungwon Yoo, Dae-Young Kim, Sung-Hee Shin, Jin Oh Na, Jinho Shin, Kiho Park, Eun Mi Lee","doi":"10.1038/s41440-025-02364-z","DOIUrl":"https://doi.org/10.1038/s41440-025-02364-z","url":null,"abstract":"<p><p>The implementation of Home Blood Pressure Monitoring (HBPM) has improved the diagnosis and treatment of hypertension. Current clinical guidelines advocate the use of validated HBPM devices. However, few studies have examined the current use of validated HBPM devices. We aimed to investigate the current status of the use of validated HBPM devices in real-world hypertensive patients. This study was conducted on Korean patients with hypertension using CareforMe®, a smartphone healthcare application which allows the patients to record their HBPM data which can be shared with their physicians. The validation status of HBPM devices was identified based on four registries: STRIDE BP, Medaval, the Japanese Society of Hypertension, and dabl® Educational Trust. From January 2022 through August 2024, 2731 patients entered the model numbers of their HBPM devices. 56.4% (n = 1539) of the population were male, and the mean age was 53.5 ± 10.8 years old. 110 models from 33 different manufacturers were identified. 97.0% (n = 2649) of the patients used upper-arm devices and 3.0% (n = 82) used wrist devices. Based on the four registries, 32.7% (n = 36) out of 110 devices were validated, and 51.5% (n = 1407) out of 2731 patients used validated devices. Patients using validated devices tend to use more expensive devices than those using non-validated devices (P < 0.0001). Among Korean patients with hypertension undergoing HBPM, 97.0% of the patients used upper-arm devices and 51.5% of the patients used validated devices. Our results proposed the urgent need for patient education and public accessibility to validated devices for the better management of patients with hypertension. The validation status of HBPM devices was identified based on four registries: STRIDE BP, Medaval, the JSH, and dabl® Educational Trust. 51.5% (n = 1,407) out of 2,731 patients used validated devices and 32.7% (n = 36) out of 110 devices were validated. Patient education and public accessibility on validated devices are urgently needed. HBPM home blood pressure monitoring; JSH Japanese Society of Hypertension.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992416","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":"Efficacy and safety of esaxerenone with and without sodium-glucose cotransporter-2 inhibitor use in hypertensive patients with type 2 diabetes mellitus: a pooled analysis of five clinical studies.","authors":"Hirohiko Motoki, Koichiro Kuwahara, Haruhito A Uchida, Jun Wada, Kazuomi Kario, Tomohiro Katsuya, Tatsuo Shimosawa, Kenichi Tsujita, Shoko Suzuki, Tomohiro Suedomi, Takashi Taguchi","doi":"10.1038/s41440-025-02347-0","DOIUrl":"10.1038/s41440-025-02347-0","url":null,"abstract":"<p><p>This pooled subanalysis of five multicenter, prospective, open-label, single-arm studies on esaxerenone aimed to evaluate the efficacy, organ-protective effects, and safety of esaxerenone in hypertensive patients with type 2 diabetes mellitus (T2DM), with and without concomitant sodium-glucose cotransporter-2 inhibitor (SGLT2i) therapy. In total, 283 and 279 patients were included in the safety (with SGLT2i, 148; without, 135) and full analysis sets (with SGLT2i; 145; without, 134), respectively. Significant changes in morning home systolic/diastolic blood pressure (SBP/DBP) from baseline to Week 12 were shown in the overall population (mean change: -11.9/-5.2 mmHg, both P < 0.001) and both SGLT2i and non-SGLT2i subgroups (-11.3/-4.8 and -12.5/-5.7 mmHg, respectively, all P < 0.001). Similar findings were observed in bedtime home and office SBP/DBP. The proportions of patients who achieved target home SBP/DBP < 135/85 mmHg were 71.2% (overall population) and 70.5% and 71.9% in the SGLT2i and non-SGLT2i subgroups, respectively. The urine albumin-to-creatinine ratio significantly improved from baseline to Week 12 in the overall population and SGLT2i subgroups (percentage change in geometric mean from baseline: -42.8%, -43.0%, and -42.6%, respectively, all P < 0.001). N-terminal pro-B-type natriuretic peptide levels improved in all groups. The incidence of serum potassium ≥5.5 mEq/L was 2.0% vs 5.2% in the SGLT2i vs non-SGLT2i subgroups. Esaxerenone demonstrated significant BP-lowering effects, and improved renal and cardiovascular parameters, regardless of SGLT2i use. Safety was consistent across groups, with the numerically lower incidence of serum potassium ≥5.5 mEq/L in the SGLT2i subgroup suggesting a potential mitigating effect of SGLT2is on the risk of hyperkalemia.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951983","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}