Hypertension Research最新文献

{"title":"Optimal blood pressure target for patients with prior stroke: A systematic review and meta-analysis.","authors":"Toshiki Maeda, Yuichiro Ohya, Shintaro Ishida, Yori Inoue, Takako Fujii, Yuki Sakamoto, Norihito Okina, Tetsutaro Niijima, Hisatomi Arima, Kazunori Toyoda, Hisashi Kai, Masatoshi Koga","doi":"10.1038/s41440-025-02183-2","DOIUrl":"https://doi.org/10.1038/s41440-025-02183-2","url":null,"abstract":"<p><p>In this systematic review of randomized controlled trials, we examined the optimal blood pressure (BP) target for patients with prior stroke, comparing intensive BP control (systolic BP [SBP] <130 mmHg) with standard BP control (SBP < 140 mmHg). Literature searches of PubMed/MEDLINE, the Cochrane Database, and Ichu-shi identified seven randomized controlled trials for quantitative analysis. Meta-analyses were performed using random-effects models, with most included trials assessed as having low risks of bias. The meta-analysis showed significant reductions in recurrent stroke (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65-0.96) and major cardiovascular events (RR, 0.86; 95% CI, 0.76-0.97) in the intensive BP control arm. Intensive BP control was more effective in reducing recurrent hemorrhagic stroke (RR, 0.33; 95% CI, 0.15-0.74) than ischemic stroke (RR, 0.87; 95% CI, 0.71-1.08). However, adverse events such as syncope or dizziness were significantly more frequent in the intensive BP control arm (RR, 1.30; 95% CI, 1.00-1.68). Absolute risk reductions (per 1,000 persons) for recurrent stroke (-14; 95% CI, -24 to -4) and major cardiovascular events (-17; 95% CI, -28 to -6) outweighed the absolute increase in syncope or dizziness (4; 95% CI, 0-9). We recommend a lower SBP target of <130 mmHg, with careful monitoring for hypotension-related symptoms, to prevent recurrent stroke and major cardiovascular events in patients with prior stroke.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648308","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":"Subclinical left ventricular dysfunction assessed by global longitudinal strain correlates with mild cognitive impairment in hypertensive patients.","authors":"Germano Junior Ferruzzi, Alfonso Campanile, Valeria Visco, Francesco Loria, Pasquale Mone, Daniele Masarone, Giuseppe Dattilo, Graziella Agnelli, Alice Moncada, Luigi Falco, Costantino Mancusi, Ilaria Fucile, Pietro Mazzeo, Eugenio Stabile, Rodolfo Citro, William Molloy, Amelia Ravera, Maddalena Illario, Cristina Gatto, Albino Carrizzo, Gaetano Santulli, Guido Iaccarino, Carmine Vecchione, Michele Ciccarelli","doi":"10.1038/s41440-025-02182-3","DOIUrl":"https://doi.org/10.1038/s41440-025-02182-3","url":null,"abstract":"<p><p>Prevention of dementia represents a public health priority. Hypertension is a risk factor for mild cognitive impairment (MCI), a precursor to progressive dementia. A great effort is underway to develop accurate and sensitive tools to detect the MCI condition in hypertensive patients. To investigate the potential association of subclinical left ventricular dysfunction expressed by the global longitudinal strain (GLS) with the MCI, defined by the Italian version of the quick mild cognitive impairment (Qmci-I). This multi-centric study included 180 consecutive hypertensive patients without medical diseases and/or drugs with known significant effects on cognition but with a not negligible comorbidity burden to avoid a possible \"hyper-normality bias\". The study cohort was classified into two main groups concerning the median value of the GLS. A weighted logistic regression model was employed after an inverse probability of treatment weighting (IPTW) analysis to characterize a potential association between GLS and MCI. Almost 41,1% of the whole study population was female. The mean age was 65,6 ± 7,2. 39 patients (21,7%) showed MCI. After IPTW, the GLS was significantly associated with the study endpoint (OR, 1,22; 95% CI: 1,07-1,39, P = 0.003). Our results highlight that the GLS is a potential predictor of MCI and, therefore, a valuable tool for establishing preventive strategies to arrest the progression toward a cognitive decline in hypertensive patients.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648310","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 inseparable relationship between constipation and blood pressure.","authors":"Tatsuhiko Kume, Masaki Mogi","doi":"10.1038/s41440-025-02185-0","DOIUrl":"https://doi.org/10.1038/s41440-025-02185-0","url":null,"abstract":"<p><p>Schematic presentation of the possible mechanisms in the association between hypertension and constipation including sympathetic overactivity, antihypertensives, and gut microbiota.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633912","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":"Exploring the high prevalence, comorbidities, and indicators of mild autonomous cortisol secretion in primary aldosteronism: a cohort study and systematic review.","authors":"Chieh Huang, Li-Yang Chang, Jia-Yuh Sheu, Yen-Ta Huang, Jui-Yi Chen, Chun-Fu Lai, Vin-Cent Wu","doi":"10.1038/s41440-025-02172-5","DOIUrl":"https://doi.org/10.1038/s41440-025-02172-5","url":null,"abstract":"<p><p>Emerging evidence has suggested a significant prevalence of mild autonomous cortisol secretion (MACS) among patients diagnosed with primary aldosteronism (PA). However, MACS's clinical characteristics and implications in PA patients remain largely unexplored. To investigate the prevalence, comorbidities, and indicators of MACS in PA patients, we conducted a retrospective cohort study including 874 PA patients with dexamethasone suppression test results in the Taiwan Primary Aldosteronism Investigators (TAIPAI) cohort between February 2011 and February 2024. Additionally, we performed a systematic review and meta-analysis of 11 studies, encompassing a total of 2882 PA patients (CRD42023486755). After including the TAIPAI cohort data in the meta-analysis, the prevalence of MACS among PA patients was 21.9% (95% confidence interval [C.I.]: 18.1, 26.2), with a negative correlation with estimated glomerular filtration rate (eGFR) (r = -0.028, P < 0.01). The characteristics associated with MACS in PA patients included older age (mean difference [MD] = 5.51 year, P < 0.01), higher plasma aldosterone concentration (MD = 5.36 ng/dL, P < 0.01), lower plasma renin activity (MD = -0.15 ng/mL/h, P < 0.01), lower eGFR (MD = -4.91 mL/min/1.73 m², P = 0.01), and larger adrenal tumor size (MD = 0.41 cm, P < 0.01). MACS was significantly associated with chronic kidney disease (odds ratio [OR] = 1.96, P < 0.01), diabetes mellitus (OR = 1.60, P = 0.04), and cardiovascular diseases (OR = 1.37, P = 0.02) among PA patients. The high prevalence and strong association of MACS with comorbidities underscore the importance of identifying it in PA patients. Clinical features such as advanced age, significant aldosterone-renin dysregulation, impaired kidney function, diabetes, cardiovascular disease, and large adrenal tumors are indicators for MACS screening in PA patients.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604636","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":"Time in target range of systolic blood pressure and eGFR slope in patients with type 2 diabetes.","authors":"Yi Cheng, Xiao-Bin Zhu, Ying-Le Xu, Jun Zou, Wendong Huang, Jingyan Tian, Chang-Sheng Sheng","doi":"10.1038/s41440-025-02173-4","DOIUrl":"https://doi.org/10.1038/s41440-025-02173-4","url":null,"abstract":"<p><p>Time in target range (TTR) of systolic blood pressure is a novel measure to assess the effect of blood pressure control. However, few studies have explored the renoprotective value of systolic TTR in patients with type 2 diabetes (T2D). We analyzed the database of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) blood pressure (BP) trial. The systolic target range was established as 120-140 and 110-130 mm Hg for the standard group and intensive therapy, respectively. Multivariate linear regression was conducted to evaluate the relationship between systolic blood pressure and estimated glomerular filtration rate (eGFR) slope. After adjusting for covariates, systolic TTR showed a significant and positive association with two measures of eGFR slope (n = 4327, P < 0.04). The correlation of systolic TTR and eGFR slope was notably stronger in CKD patients (n = 1635) compared to those without (P for interaction < 0.05). When analyzing systolic TTR as a categorical variable, participants with CKD in the highest systolic TTR quantile had a significantly positive relationship with eGFR slope (P ≤ 0.0001). These findings were consistently observed across further subgroup analyses. Among T2D patients, systolic TTR exhibited a significant and positive relation to eGFR slope, with a stronger relationship noted in individuals diagnosed with CKD. This underscores the critical role of stable blood pressure control for renoprotection in patients with T2D, particularly in those with CKD. (Trial Registration: ClinicalTrials.gov number: NCT00000620).</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596767","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 prognostic impact of home blood pressure measurements in patients with stage B heart failure.","authors":"Takahiro Komori, Satoshi Hoshide, Kazuomi Kario","doi":"10.1038/s41440-025-02174-3","DOIUrl":"https://doi.org/10.1038/s41440-025-02174-3","url":null,"abstract":"<p><p>Although hypertension is a risk factor for cardiovascular (CVD) events in stage B heart failure (HF), data on the prognostic value of home blood pressure (BP) measurements in stage B HF are limited. We retrospectively analyzed the cases of 568 patients with stage B HF and at least one cardiovascular risk factor who underwent home BP monitoring. Stage B HF was defined as BNP ≥ 35 pg/mL or NT-proBNP ≥125 pg/mL, Troponin T > 0.014 ng/mL, LVEF < 50%, enlarged left ventricular dimensions in diastole (men: ≥60 mm; women: ≥54 mm), enlarged left atrium (men: >40 mm; women: >38 mm), or increased left ventricular mass (men: >115 g/m²; women: >95 g/m²). Office hypertension was defined as systolic BP ≥ 140 mmHg. Home BP was measured in the morning, evening, and nighttime; morning/evening home hypertension was defined as ≥135 mmHg and nighttime home hypertension as ≥120 mmHg. During a mean follow-up of 7.8 ± 3.6 years, 66 CVD events occurred. An unadjusted Cox regression model gave the following hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD-events risk in patients with office, morning, evening, and nighttime home hypertension: HR 1.69 (95% CI 1.03-2.78), 1.73 (1.02-2.95), 1.44 (0.89-2.33) and 2.33 (1.34-4.04), respectively. In a multivariate Cox regression analysis adjusting for significant variables, the association with CVD events remained only for nighttime home hypertension (HR 1.89; 95% CI 1.06-3.38), not other hypertension types. In conclusion, hypertension defined based on nighttime home BP was associated with CVD-events risk in stage B HF patients.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596766","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":"Hypertensive women with dyspnea exhibit an unfavorable central blood pressure response to exercise.","authors":"Paulina Skalska, Małgorzata Kurpaska, Małgorzata Banak, Paweł Krzesiński","doi":"10.1038/s41440-025-02171-6","DOIUrl":"https://doi.org/10.1038/s41440-025-02171-6","url":null,"abstract":"<p><p>Limited exercise tolerance and dyspnea in patients with uncomplicated hypertension may pose a diagnostic challenge, particularly when blood pressure is normal and assessment results do not support a diagnosis of heart failure. The purpose of this study was to assess the differences in central blood pressure (cBP) response to exercise between females with hypertension and good exercise tolerance (non-dyspneic females, nDFs; n = 27) and those with dyspnea on exertion (dyspneic females, DFs; n = 25). We also investigated the relations of cBP and its dynamics with peak oxygen consumption (peak VO₂) and peak heart rate (peak HR) assessed by cardiopulmonary exercise test (CPET) and peak cardiac output (peak CO) assessed by impedance cardiography. Fifty-two females (mean age 54.5 ± 8.2 years) underwent applanation tonometry during CPET to assess the augmentation index (AIx), cBP, and central pulse pressure (cPP) before exercise (REST), at minute 3-rd of exercise (Ex), and at minutes: 1-st (R1) and 4-th of post-exercise rest (R2). In comparison with nDFs, DFs showed significantly higher cPP_Ex, AIx_Ex, and AIx_R1. The two subgroups showed no differences in cPP or Alx values either before exercise or at R2. In comparison with nDFs, the DFs had a less pronounced change in AIx values during post-exercise rest. There were negative correlations between peak HR and: AIx_R1, AIx_R2, change in AIx (R1-R2), between peak VO₂ and: AIx_R1, AIx_R1-R2; between peak CO and: AIx_R1, AIx_R2, AIx_R1-R2. DFs presented a different cBP response to exercise than nDFs. Assessing cBP via applanation tonometry may prove useful in identifying hemodynamic abnormalities associated with limited exercise tolerance.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596848","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":"Effect of population-based sodium reduction interventions on blood pressure: a systematic review and meta-analysis of randomized trials.","authors":"Einosuke Mizuta, Kento Kitada, Sayaka Nagata, Sayoko Ogura, Atsushi Sakima, Jun Suzuki, Hisatomi Arima, Katsuyuki Miura","doi":"10.1038/s41440-025-02181-4","DOIUrl":"10.1038/s41440-025-02181-4","url":null,"abstract":"<p><p>This systematic review and meta-analysis included cluster randomized controlled trials that compared population-based sodium reduction interventions with usual care for blood pressure (BP) management. We searched PubMed, Cochrane Central Register of Controlled Trials, and IchuShi-Web and utilized a random-effects meta-analysis of the weighted mean difference (MD) in the comparison groups to collect data from the included trials. The primary outcome includes the pooled MD of office BP from baseline to each follow-up period. This meta-analysis considered 36 articles with 66,803 participants to be eligible. The population-based sodium reduction interventions decreased office systolic BP (SBP) compared with usual care in 36 studies (MD: -2.64 mmHg [95% confidence interval: -3.48- to 1.80]), with evidence of heterogeneity. Office SBP exhibited significant benefits among in adults (30 studies) and adults/children (1 study) but not in children (5 studies). Furthermore, office diastolic BP demonstrated comparable benefits with office SBP. Sensitivity analyses by cluster type in adults revealed that the workplace-based intervention exerted a greater SBP-lowering effect than the clinic/facility-based intervention. However, no significant difference was observed in the SBP-lowering effect by intervention type. The interventions were more effective in hypertensive cohorts compared with non-hypertensive cohorts and in Asian cohorts compared with non-Asian cohorts. Additionally, the benefits for secondary outcomes, including salt (sodium chloride) intake, were similar to those for office BP. In conclusion, population-based sodium reduction interventions improved BP management compared with usual care. The benefits along with the observed heterogeneity should be considered prudent for implementation in public health and clinical practices. This meta-analysis considered 36 studies with 66,803 participants to be eligible. The population-based sodium reduction interventions decreased office BP compared with usual care in 36 studies, with evidence of heterogeneity. Sensitivity analyses by cluster type in adults (30 studies) revealed that community-, family-, school-, and workplace-based interventions reduced office SBP. Concerning intervention type, sodium reduction counseling, salt substitution, and monitoring decreased office SBP. Interventions were more effective in hypertensive cohorts compared with non-hypertensive cohorts. The benefits for salt intake (22 studies) and urinary sodium excretion (17 studies) were comparable to those for office BP. BP: blood pressure; DBP: diastolic blood pressure; MD: mean difference; Na: sodium; RR: risk ratio; SBP: systolic blood pressure.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585540","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 research 2024 update and perspectives: blood pressure management.","authors":"Yoichi Nozato","doi":"10.1038/s41440-025-02130-1","DOIUrl":"10.1038/s41440-025-02130-1","url":null,"abstract":"<p><p>This mini-review article presents a comprehensive update on recent advancements in blood pressure management, based on original research published between 2023 and 2024. As part of the \"Hypertension Research 2024 Update and Perspectives\", the review integrates insights from the JSH2024 Fukuoka Declaration, emphasizing the concept of \"NEO-HYPERTENSION harmonized with society\". The strategies proposed in this review aim to realize this concept by promoting lifelong blood pressure management, preemptive medicine, and leveraging digital health technologies. Key strategies include adherence to treatment guidelines, overcoming clinical inertia, and the utilization of new digital tools and novel antihypertensive agents. Additionally, the review explores the significance of multidisciplinary collaboration and non-pharmacological therapies, as well as the importance of setting individualized treatment goals tailored to patients' unique backgrounds. By aligning with the JSH's vision, this review offers a fresh perspective on contemporary clinical practices and future directions. These updates aim to contribute to improved patient outcomes and global health advancements in hypertension care.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585542","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":"Factors associated with blood pressure regulation in vascular smooth muscle cells.","authors":"Masaki Mogi, Masayoshi Kukida","doi":"10.1038/s41440-025-02170-7","DOIUrl":"10.1038/s41440-025-02170-7","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585541","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}