Hypertension Research最新文献

{"title":"Congratulatory messages on the publication of this guidance.","authors":"Toshiharu Ikaga","doi":"10.1038/s41440-026-02824-0","DOIUrl":"https://doi.org/10.1038/s41440-026-02824-0","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147620","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 Japanese Society of Hypertension Practical Consensus Guidelines for Seasonal Blood Pressure Management.","authors":"Kazuomi Kario, Toshiharu Ikaga, Wataru Umishio, Yasuharu Tabara, Keigo Saeki, Shigeru Shibata, Hirofumi Tomita, Yoshihisa Fujino, Satoshi Hoshide, Masaki Mogi, Koichi Yamamoto, Kei Asayama, Kimika Arakawa, Hisatomi Arima, Shintaro Ando, Mari Ishida, Hiroyuki Ohbayashi, Osamu Okazaki, Tomonori Okamura, Kenichi Katsurada, Shun Kawakubo, Wakako Kawarazaki, Takuya Kishi, Kento Kitada, Ryosuke Komi, Michihiro Satoh, Keisuke Shinohara, Naoko Tomitani, Hironori Nakagami, Keisuke Narita, Masafumi Nishizawa, Akira Nishiyama, Kaori Hayashi, Ako Fukami, Takeshi Fujiwara, Katsuyuki Miura, Tetsuro Yoshida, Hiromi Rakugi","doi":"10.1038/s41440-026-02826-y","DOIUrl":"https://doi.org/10.1038/s41440-026-02826-y","url":null,"abstract":"<p><p>Blood pressure (BP) and cardiovascular disease risk show clear seasonal variations. In addition to increases in BP and cardiovascular events associated with cold exposure during winter, attention should also be paid to high temperatures, dehydration, excessive BP lowering, and increases in nighttime BP during summer. In recent years, it has become increasingly clear that not only outdoor temperature but also indoor temperature, temperature differences within the home, living environments, and socioeconomic factors are associated with BP fluctuations, increasing the importance of year-round BP management that takes seasonal and thermal environmental factors into consideration. This practical guidance document complements existing guidelines for the management and treatment of hypertension and provides practical direction for BP assessment, lifestyle guidance, interventions targeting the residential environment, and adjustment of antihypertensive therapy according to seasonal changes based on current evidence and expert consensus. Specifically, ten key questions relating to seasonal variations in BP, cardiovascular risk factors and events, and hypertension management are covered. This includes the consideration of appropriate indoor temperatures and temperature differences, attention to BP variability, and use/modification of lifestyle interventions and antihypertensive pharmacotherapy. This guidance positions seasonal BP management not only as part of the clinical management of individual patients but also as an area of \"Implementation Hypertension\" that connects the home, housing, local communities, and government. Going forward, standardization of temperature exposure indices, accumulation of year-round home BP data, development of intervention models for vulnerable populations, and promotion of multidisciplinary and cross-sectoral collaboration, including improvement of residential environments, will be required.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147633","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":"Age-stratified efficacy and safety of esaxerenone versus angiotensin II receptor blockers in older patients with hypertension: a predefined subanalysis of the ESCORT-HT study.","authors":"Kazuomi Kario, Hiroyuki Ohbayashi, Hajime Ishii, Mitsutoshi Kato, Minoru Nozaki, Norio Abiru, Toshiki Fukui, Kazushi Nomura, Yasushi Fukushima, Naoki Itabashi, Kazuaki Uchiyama, Masafumi Nishizawa, Yoshiki Hata, Noriko Nakamura, Satoshi Kodono, Kunio Hirano, Tomohiro Katsuya, Tatsuo Shimosawa, Mitsuru Ohishi, Kazuhito Shiosakai, Taketoshi Furugori, Takashi Taguchi","doi":"10.1038/s41440-026-02757-8","DOIUrl":"https://doi.org/10.1038/s41440-026-02757-8","url":null,"abstract":"<p><p>The ESCORT-HT study recently demonstrated non-inferiority of esaxerenone to angiotensin II receptor blockers (ARBs) in lowering morning home systolic blood pressure (SBP) in Japanese patients aged ≥65 years with inadequately controlled hypertension on amlodipine. This predefined subgroup analysis of the ESCORT-HT study analyzed age-related differences in the efficacy and safety of esaxerenone relative to ARBs. In the 65-74-year subgroup, 98 patients were treated with esaxerenone and 94 with an ARB; in the ≥75-year subgroup, 104 were treated with esaxerenone and 106 with an ARB. The least squares mean difference in morning home SBP between the two treatment groups at end of treatment was -1.1 (95% confidence interval [CI] -3.8, 1.6) mmHg for the 65-74-year subgroup and -2.2 (95% CI -5.2, 0.9) mmHg for the ≥75-year subgroup. The upper bound of the 95% CI was within the pre-defined non-inferiority margin of <3.8 mmHg. The urine albumin-to-creatinine ratio decreased in all groups at Week 12, regardless of age or treatment, and N-terminal pro-B-type natriuretic peptide levels decreased in esaxerenone-treated patients, regardless of age. The incidence of treatment-emergent adverse events was 34.3% (esaxerenone) and 32.0% (ARB) in patients 65-74 years, and 16.7% and 29.6%, respectively, in patients aged ≥75 years. There were no notable increases in the incidence of hyperkalemia or hypokalemia, relative to ARBs, in any of the age subgroups. This predefined subgroup analysis of the ESCORT-HT study showed antihypertensive effects consistent with the non-inferiority of esaxerenone to ARBs in both age groups, and suggested a potential cardioprotective effect, including for patients aged ≥75 years.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147275","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":"Can intensified activities of the Japanese Society of Hypertension attenuate the seasonal surge in cardiovascular disease? From morning blood pressure and the living environment to seasonally adaptive implementation hypertension.","authors":"Kazuomi Kario","doi":"10.1038/s41440-026-02821-3","DOIUrl":"https://doi.org/10.1038/s41440-026-02821-3","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148957","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 Japanese Society of Hypertension Practical Consensus Guidelines for Seasonal Blood Pressure Management: Preface.","authors":"Kazuomi Kario","doi":"10.1038/s41440-026-02822-2","DOIUrl":"https://doi.org/10.1038/s41440-026-02822-2","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147770","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":"Ultrasound renal denervation for treatment-resistant hypertension with severe left ventricular hypertrophy.","authors":"Mizuki Miura, Osamu Yamazaki, Masafumi Saito, Kanon Hiraike, Yoshihiro Tomomitsu, Etsuko Sawabe, Ayaka Aihara, Ryosuke Mizuta, Kumiko Ando, Daigoro Hirohama, Kenta Tsutsui, Yusuke Watanabe, Ken Kozuma, Shigeru Shibata","doi":"10.1038/s41440-026-02819-x","DOIUrl":"https://doi.org/10.1038/s41440-026-02819-x","url":null,"abstract":"<p><p>Resistant hypertension with left ventricular hypertrophy requires aggressive treatment to reduce cardiovascular risk. Ultrasound renal denervation safely attenuates sympathetic activity and lowers blood pressure. We performed step-by-step image-guided renal denervation, demonstrating procedural feasibility, safety, and early blood pressure reduction with potential benefits for left ventricular remodeling.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149760","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":"Regional effect of population-based programs promoting salt reduction and potassium intake in Hokkaido: a post hoc analysis of the PoSPIP.","authors":"Hirofumi Sakuma, Katsushi Yoshita, Yukari Takemi, Takashi Hisamatsu, Rumi Tsukinoki, Hitomi Hayabuchi, Yukiko Okami, Kaori Kitaoka, Atsushi Hozawa, Takayoshi Ohkubo, Naoyuki Hasebe, Katsuyuki Miura, Naoki Nakagawa","doi":"10.1038/s41440-026-02846-8","DOIUrl":"https://doi.org/10.1038/s41440-026-02846-8","url":null,"abstract":"<p><p>The Population-based Sodium/Potassium Improvement Program is a nonrandomized population-based intervention implemented by the Japanese Society of Hypertension across multiple municipalities and workplaces in Japan. This post hoc regional analysis focused on two municipalities in Hokkaido-namely, Higashikagura, which received standard support, and Mashike, which received intensive support consisting of on-site urinary sodium-to-potassium (Na/K) ratio measurement, immediate feedback, repeated health guidance, and food-environment improvement. A total of 431 participants who underwent annual health checkups in 2021 and 2022 and had urinary Na/K ratio data at both time points (standard support group, n = 218; intensive support group, n = 213) were included. One-year changes in the urinary Na/K ratio, estimated salt and potassium intakes, blood pressure (BP), and other clinical measures were compared between the groups using multivariable linear regression. The proportion of participants achieving urinary Na/K ratio targets increased in the intensive support group. A significant group-by-time interaction was observed for the <2 threshold (OR 2.62, 95% CI: 1.25-5.50), but not for the <4 threshold. After adjustment for covariates, estimated salt intake decreased more in the intensive support group than in the standard support group (adjusted group difference: -0.53 g/day, 95% confidence interval: -0.95 to -0.12). Changes in the urinary Na/K ratio, estimated potassium intake, and systolic and diastolic BP did not significantly differ between the groups. Intensive support incorporating urinary Na/K ratio measurement, immediate feedback, and repeated multidisciplinary guidance may promote salt reduction in local community settings.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148168","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":"Hypertension: a missing piece in HFpEF?","authors":"Michiaki Nagai, Keigo Dote, Sunny S Po, Tarun W Dasari","doi":"10.1038/s41440-026-02855-7","DOIUrl":"https://doi.org/10.1038/s41440-026-02855-7","url":null,"abstract":"<p><p>As population aging accelerates and unhealthy lifestyle habits become increasingly prevalent, the burden of heart failure with preserved ejection fraction (HFpEF) continues to rise. Hypertension, obesity, and atrial fibrillation (AF) are major contributors to the development and progression of HFpEF. Among these risk factors, hypertension serves as a central hub linking cardiovascular and metabolic abnormalities. This review discusses the relationship between hypertension and HFpEF, focusing on sympathovagal imbalance as a common mechanism underlying hypertension, obesity, and AF. We summarize evidence regarding the contribution of autonomic dysregulation to HFpEF pathogenesis and examine the therapeutic potential of targeting autonomic function. Current evidence suggests that a systolic blood pressure target of <130 mmHg may be appropriate for patients with HFpEF. In addition to established pharmacological therapies, emerging neuromodulatory approaches, particularly low-level transcutaneous tragus stimulation, may represent promising adjunctive treatment strategies. Improved understanding of these interrelated mechanisms may facilitate more individualized management of HFpEF.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147961","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":"Concept of organ dysfunction revealed by shift in thinking from V = IR to W = VI.","authors":"Masaki Mogi, Shuang Liu, Yasuyuki Suzuki, Satoshi Hoshide, Kazuomi Kario","doi":"10.1038/s41440-026-02839-7","DOIUrl":"https://doi.org/10.1038/s41440-026-02839-7","url":null,"abstract":"<p><p>Blood pressure is expressed as V (blood pressure) = I (circulating blood volume or cardiac output) × R (peripheral vascular resistance), based on Ohm's law (V (voltage) = I (current) × R (resistance)). Antihypertensive drugs that reduce either I or R are used. On the other hand, the electrical energy consumed per unit time is power (W), which is expressed as W = VI. If we consider the energy consumed by each organ to be W, and assume that an organ consumes a constant amount of functional bioenergy requirement (FBR), then V and I work in a complementary manner. It is conceivable that if a decrease in blood flow occurs first due to conditions such as arteriosclerosis or peripheral circulatory failure, peripheral blood pressure will rise compensatorily; conversely, if systemic blood pressure rises first, tissue blood flow will decrease compensatorily, potentially leading to chronic ischemia. In this medical hypothesis, I would like to consider a shift in perspective from V = IR to W = VI in blood pressure management-a field that has traditionally focused on peripheral vascular resistance (R)-by shifting the focus to blood pressure regulation aimed at maintaining FBR in tissues. Conventional blood pressure regulation is based on Ohm's law (V = IR), where antihypertensive therapy primarily targets cardiac output (I) or peripheral vascular resistance (R) to reduce blood pressure. We propose a complementary framework based on W = VI, in which blood pressure (V) and tissue perfusion (I) are regulated cooperatively to preserve the functional bioenergy requirement (FBR) of tissues. Reduced tissue perfusion may induce a compensatory blood pressure elevation, whereas primary blood pressure elevation may trigger autoregulatory responses that limit the pressure-driven increase in tissue blood flow, potentially resulting in chronic tissue ischemia. This paradigm highlights a shift from lowering visible blood pressure alone toward preserving the invisible FBR of tissues. This figure was created with the assistance of generative AI (GPT-5.6 Thinking) based on the content of this paper. The authors have verified the content.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127287","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 impact of the \"Ibaraki Zero-Hypertension Action\" campaign on improving health awareness among residents and blood pressure management.","authors":"Daigo Hiraya, Tomoko Ishizu, Hiroshi Yamagami, Mikito Hayakawa, Yuji Matsumaru, Yuji Hiramatsu","doi":"10.1038/s41440-026-02835-x","DOIUrl":"https://doi.org/10.1038/s41440-026-02835-x","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108910","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}