Hypertension Research最新文献

{"title":"Beyond the acute phase: the evidence gap in hypertensive emergency in Japan.","authors":"Shigeru Shibata","doi":"10.1038/s41440-026-02841-z","DOIUrl":"https://doi.org/10.1038/s41440-026-02841-z","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":"149108778","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 in Heart Failure With Reduced Ejection Fraction: Cause or Disease Modifier?","authors":"Maria Giulia Bellicini","doi":"10.1038/s41440-026-02815-1","DOIUrl":"10.1038/s41440-026-02815-1","url":null,"abstract":"<p><p>The coexistence of hypertension and HFrEF should be distinguished from a causal progression from hypertensive heart disease to systolic heart failure. Available experimental, longitudinal, and clinical evidence does not consistently demonstrate such a transition in the absence of additional non hypertensive myocardial injury. In this context, the intriguing association reported by Harada et al. between changes in serum adiponectin and improvement in left ventricular ejection fraction specifically in patients with HFrEF and hypertension may identify hypertension as a modifier of the metabolic and inflammatory response of the failing myocardium rather than as the primary cause of systolic dysfunction. (see graphical abstract).</p>","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":"149108725","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":"Toward patient-centered blood pressure monitoring: first evaluation of a low-pressure and rapid oscillometric method for reducing cuff-related measurement burden.","authors":"Yuki Ota, Mitsuo Kuwabara, Kazuomi Kario","doi":"10.1038/s41440-026-02838-8","DOIUrl":"https://doi.org/10.1038/s41440-026-02838-8","url":null,"abstract":"<p><p>Out-of-office blood pressure (BP) monitoring is essential for hypertension management. Repeated cuff inflation may cause discomfort and reduce acceptance of out-of-office BP monitoring. To address this, we developed a novel low-pressure and rapid oscillometric method designed to reduce maximum cuff pressure (MaxCP) and measurement duration. In this participant-blinded crossover study, we evaluated cuff-related measurement burden using the Omron HEM-7290T, the first automated upper-arm BP monitor to use the novel method. The HEM-7290T was compared with an otherwise identical device using a conventional inflation-based method (Reference A; n = 110 participants) and with a conventional deflation-based oscillometric BP monitor (Reference B; n = 93 participants). The primary endpoint was the difference in visual analog scale (VAS) score for perceived cuff tightness. Compared with Reference A and Reference B, HEM-7290T reduced VAS scores by 8.6 points (95% CI, 6.5-10.8; p < 0.001) and 9.5 points (95% CI, 7.1-11.8; p < 0.001), respectively. Greater reductions in VAS scores were associated with more frequent selection of the HEM-7290T measurement as the one associated with the least perceived cuff tightness. Compared with Reference A and Reference B, respectively, MaxCP was reduced by 32.0 mmHg and 51.0 mmHg, while measurement duration was reduced by 6.8 s and 14.5 s. In conclusion, the novel low-pressure and rapid oscillometric method significantly reduced subjective and objective measures of cuff-related measurement burden, and measurements performed with the HEM-7290T were more frequently selected as involving the least cuff tightness than measurements performed using conventional methods.</p>","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":"149108881","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 C-terminal frameshift mutation of ELN causes non-stenotic high-renin hypertension and systemic arterial dysplasia: implications for preventing aortic catastrophes.","authors":"Dong-Yan Zhang, Yi Chen, Meng-Ya Chen, Yi-Bang Cheng, Jin Zhang, Ting-Yan Xu, Ji-Guang Wang","doi":"10.1038/s41440-026-02843-x","DOIUrl":"https://doi.org/10.1038/s41440-026-02843-x","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108768","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":"Association of hypertension specialist treatment with blood pressure control in Japanese primary care: The J-DOME study.","authors":"Daigoro Hirohama, Shigeru Shibata, Narumi Eguchi, Tsuguru Hatta, Kazuomi Kario, Tomohiro Katsuya, Kazuo Kobayashi, Akira Nishiyama, Mitsuhiko Noda, Yoichi Nozato, Kensuke Sasaki, Keisuke Shinohara, Emi Ushigome, Kei Asayama","doi":"10.1038/s41440-026-02833-z","DOIUrl":"https://doi.org/10.1038/s41440-026-02833-z","url":null,"abstract":"<p><p>Although hypertension is a major contributor to cardiovascular complications, real-world blood pressure (BP) control in primary care and the role of hypertension specialists remain incompletely characterized. We evaluated BP control and associated factors using the Japan Medical Association Database of Clinical Medicine (J-DOME), a nationwide primary care registry. This cross-sectional study included patients with hypertension registered in 2024, categorized by treatment by specialists certified by the Japanese Society of Hypertension. Multivariable logistic regression identified factors associated with achieving office BP < 130/80 mmHg. Among 2663 patients (43.6% women; mean age, 71.4 years), 545 were treated by hypertension specialists. Mean BP was 134.4/74.8 mmHg, and the mean number of antihypertensive drugs was 1.6. Systolic BP was similar between specialist- and non-specialist-treated patients (135.1 vs. 134.2 mmHg; p = 0.28), whereas diastolic BP (76.1 vs. 74.5 mmHg; p = 0.0060) and the number of drugs (1.9 vs. 1.6; p < 0.0001) were higher in the specialist-treated group. Target BP achievement rate was lower in the specialist-treated group (30.8% vs. 37.3%; p = 0.0058), however, this difference was not observed among patients aged <75 years (33.2% vs. 35.4%; p = 0.55). The multivariable-adjusted model revealed that diabetes mellitus (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.08-1.61) and a higher number of drugs (OR per additional drug, 1.12; 95% CI, 1.04-1.22) were associated with higher target achievement, whereas overweight (OR, 0.70; 95% CI, 0.58-0.85), obesity (OR, 0.57; 95% CI, 0.42-0.77), and specialist treatment (OR, 0.77; 95% CI, 0.61-0.96) were associated with lower achievement. Office BP control remains suboptimal in Japanese primary care. Lower achievement among specialist-treated patients despite more drugs may reflect the concentration of difficult-to-control hypertension in specialist care. Continued efforts to improve hypertension management, particularly in patients with obesity, are warranted.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108745","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":"Integrated morphological and transcriptomic analysis of bone disorders in aldosterone-salt hypertension.","authors":"Mika Kawagoe, Daigoro Hirohama, Masaki Ueno, Ken Kaseda, Yoshifuru Tamura, Shigeru Shibata","doi":"10.1038/s41440-026-02832-0","DOIUrl":"https://doi.org/10.1038/s41440-026-02832-0","url":null,"abstract":"<p><p>Although excessive dietary sodium intake is a well-recognized risk factor for hypertension, accumulating evidence indicates that it leads to broader metabolic consequences. Here, we investigated the renal and skeletal consequences of high salt loading and the protective effects of esaxerenone, a selective nonsteroidal mineralocorticoid receptor (MR) antagonist. Male Sprague-Dawley rats were infused with aldosterone and fed an 8% sodium chloride diet for 4 weeks (Aldo-HS), with or without esaxerenone. Trabecular bone architecture was assessed by micro-computed tomography, three-dimensional morphometry, and histomorphometry. Kidney and bone transcriptomes were analyzed using RNA sequencing and weighted gene co-expression network analysis. Aldo-HS rats developed marked renal calcium wasting without changes in serum calcium, phosphate, parathyroid hormone, or fibroblast growth factor 23 levels. Fractional calcium excretion was strongly inversely correlated with trabecular bone volume (r = -0.74, p < 0.001). Aldosterone-salt loading induced substantial trabecular bone loss, which was prevented by esaxerenone. Bone transcriptomic analysis demonstrated suppression of extracellular matrix gene programs; a collagen-enriched gene module (including Col1a1, Col1a2, Col11a1) was tightly linked to calcium wasting (r = -0.97, p < 0.001), partially restored by MR blockade, and overlapped with loci associated with bone mineral density in human genome-wide association studies. Aldosterone-salt loading induces trabecular bone loss accompanied by imbalance in bone remodeling and renal calcium wasting. MR blockade preserves skeletal integrity, supporting a modifiable bone-kidney axis and providing translational insight into skeletal complications of mineralocorticoid excess.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108720","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":"Seasonal variation in day-to-day blood pressure variability: large-scale within-individual home blood pressure data.","authors":"Michihiro Satoh, Yuya Suzuki, Hiroki Nobayashi, Yutaro Iwabe, Seiya Izumi, Maya Toyama, Takahisa Murakami, Hideaki Hashimoto, Shingo Nakayama, Hirohito Metoki","doi":"10.1038/s41440-026-02834-y","DOIUrl":"https://doi.org/10.1038/s41440-026-02834-y","url":null,"abstract":"<p><p>Day-to-day home blood pressure (BP) variability predicts cardiovascular and cognitive risk, but whether it shows seasonal variation within the same individual remains uncertain. We examined its seasonal patterns using repeated personal health record measurements. We analyzed a Japanese health-insurance database (DeSC database) linked to home BP from a mobile application. Monthly trajectories and winter-summer differences in mean home morning BP, its within-individual standard deviation (SD), and variability independent of the mean (VIM) were estimated using linear mixed-effects models stratified by antihypertensive treatment and sex, with age category as a fixed effect. Winter-summer differences were standardized by the model-based total SD for comparison across indices. Among the 7,908 individuals (mean age, 55 years), 13.6% were untreated females, 10.2% were treated females, 31.1% were untreated males, and 45.1% were treated males. Home systolic BP peaked in December or January and reached its nadir in July-August, regardless of antihypertensive treatment status, sex, or age category, with winter-summer differences of approximately 3-4 mmHg (standardized differences: 0.28-0.41). The SD of home systolic BP followed a similar seasonal pattern (standardized differences: 0.07-0.18). Although winter-summer differences in VIM were also significant in several strata, particularly among males, their magnitudes were small (standardized differences ≤0.09). Home BP levels showed clear seasonal variation, whereas seasonal differences in day-to-day BP variability were minor when indices less dependent on average BP were used. The apparent winter increase in day-to-day BP variability unadjusted for BP level is largely attributable to the seasonal BP elevation.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108814","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":"Telemonitoring in the era of digital hypertension: beyond remote blood pressure monitoring.","authors":"Naoko Tomitani, Kazuomi Kario","doi":"10.1038/s41440-026-02827-x","DOIUrl":"https://doi.org/10.1038/s41440-026-02827-x","url":null,"abstract":"<p><p>Telemonitoring, typically incorporating home blood pressure (BP) monitoring, has become an established component of hypertension management. Conventional telemonitoring has primarily relied on remote transmission of BP measurements to support clinician-directed treatment adjustment. However, recent advances in digital health technologies and the emergence of digital hypertension have substantially broadened the role of telemonitoring in hypertension care. Within the framework of digital hypertension, telemonitoring is evolving beyond simple BP surveillance in three major domains. First, advances in data monitoring enable the integration of multidimensional health information, including physical activity, sleep patterns, medication adherence, and environmental exposures, with longitudinal BP measurements. Second, physician-support technologies, such as automated data integration, clinical decision-support systems, and artificial intelligence-based analytics, facilitate the interpretation of large-scale patient-generated data and support timely clinical intervention. Third, patient-support technologies, including digital therapeutics, provide continuous behavioral interventions and self-management support between clinic visits. Despite these advances, several challenges remain, including ensuring data quality and standardization, integration into clinical workflows, long-term patient engagement, digital inequalities, and concerns regarding privacy and data governance. Future research should focus on optimizing the clinical use of multidimensional health data, evaluating the effects of advanced telemonitoring strategies on long-term clinical outcomes, and establishing effective implementation models for routine practice. In the era of digital hypertension, telemonitoring is evolving from a BP monitoring tool into a comprehensive platform for personalized, data-driven, and continuous hypertension management.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108912","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":"Pathophysiological role of adipocyte-derived adrenomedullin.","authors":"Sayaka Nagata","doi":"10.1038/s41440-026-02831-1","DOIUrl":"https://doi.org/10.1038/s41440-026-02831-1","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108766","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":"Intensive blood pressure lowering across metabolic syndrome severity: balancing absolute benefits and relative effects.","authors":"Satoko Sakata","doi":"10.1038/s41440-026-02829-9","DOIUrl":"https://doi.org/10.1038/s41440-026-02829-9","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108789","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}