Hypertension Research最新文献

{"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}

{"title":"Periarterial nerves along the human hepatic artery: anatomical determinants for cardiometabolic neuromodulation.","authors":"Mert Tokcan, Mathias Hohl, Lucas Lauder, Alexander Hermens, Helge Struthoff, Markus Therre, Carolin Victoria Schneider, Kai Markus Schneider, Stephanie Bettink, Jan Federspiel, Thomas Tschernig, Bruno Scheller, Saarraaken Kulenthiran, Felix Mahfoud, Michael Böhm","doi":"10.1038/s41440-026-02830-2","DOIUrl":"https://doi.org/10.1038/s41440-026-02830-2","url":null,"abstract":"<p><p>Preclinical and early clinical studies suggest that catheter-based hepatic artery denervation is a neuromodulation strategy with potential relevance for blood pressure and cardiometabolic regulation, but high-resolution human data on nerves along the hepatic arterial course remain limited. This study aimed to characterize periarterial nerves along the human hepatic artery and to identify anatomically favorable target regions for catheter-based denervation. Hepatic arteries with surrounding tissue were excised from 10 human donors. Immunofluorescence staining was used to assess periarterial nerve density and diameter. A total of 13,165 nerves were analyzed. Median nerve diameter decreased from 93 µm [IQR 54-165] at 1 cm to 72 µm [IQR 48-120] at 7 cm distal to the coeliac trunk (p < 0.001). The largest nerves were predominantly located in the posterior and inferior quadrants, with median diameters of 85 µm [IQR 48-176] and 85 µm [IQR 48-158], respectively. Mean nerve density was significantly higher in proximal (1-3 cm) than distal (4-7 cm) segments (233 ± 124 vs. 159 ± 76 nerves/cm², p < 0.001). Lumen-nerve distance was significantly shorter in proximal than distal segments (2.03 mm [IQR 1.23-3.58] vs. 2.57 mm [IQR 1.26-4.67], p < 0.001) and was shortest in the anterior quadrant (1.75 mm [IQR 1.10-3.23], p < 0.001). Thus, proximal hepatic artery segments are characterized by larger nerve diameters, higher nerve density, and shorter lumen-nerve distances than distal segments. These anatomical findings identify a potentially favorable target zone and may help guide the safe and effective application of hepatic denervation in humans. Size and distribution of periarterial hepatic artery nerves across segments. Plots show the proportion of nerves located within <2, <4, <6, <8, and <10 mm from the arterial lumen, and the distribution of nerve diameters across predefined size categories (<50 µm, 50-69 µm, 70-89 µm, 90-110 µm, and >110 µm). Colors indicate the corresponding nerve size categories, and quadrants are indicated.</p>","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":"149108850","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":"Changes in segmental arterial stiffness and volume dynamics across the arterial tree during noradrenaline administration in rabbits.","authors":"Shuji Sato, Mao Takahashi, Yoshinobu Nagasawa, Megumi Aimoto, Satoshi Kawakami, Kazuhiro Shimizu, Kohji Shirai, Akira Takahara","doi":"10.1038/s41440-026-02828-w","DOIUrl":"10.1038/s41440-026-02828-w","url":null,"abstract":"<p><p>Vascular function depends on arterial stiffness and volume dynamics; however, segmental differences remain unclear. Segmental arterial stiffness can be assessed using a cardio-ankle vascular index (CAVI)-based stiffness parameter (segmental-β), and volume changes can be estimated using intravascular ultrasound (IVUS). In this study, segmental-β and arterial caliber changes in the aorta and iliofemoral arteries were investigated during noradrenaline (NAD) administration with the aim of clarifying segmental vascular function and its interactions. Anesthetized rabbits received low, medium, and high NAD doses (10, 100, and 1000 μg/kg) and hemodynamic parameters were measured. The results showed that blood pressure and peripheral vascular resistance increased in a dose-dependent manner. IVUS demonstrated dose-dependent increases in arterial caliber in both the aorta and iliac arteries, as well as in estimated aortic volume. At low and medium NAD doses, iliac-β increased, whereas aortic-β decreased. In contrast, at the high NAD dose, iliac-β turned downward, and aortic-β turned upward. Despite uniform arterial dilation associated with volume centralization induced by peripheral arteriolar vasoconstriction, arterial stiffness exhibited reciprocal segmental changes. Overall, this intersegmental vascular response may be conceptualized as an \"arterial ballooning chain effect\" involving elastic arteries, muscular arteries, and arterioles under strong vasoconstrictive stress. This phenomenon might be an adaptation of central blood pooling among various arterial trees.</p>","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":"149108791","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":"A scoping review of salt reduction guidance for the food industry.","authors":"Ikuko Kashino, Miwa Yamaguchi, Katsuyuki Miura, Nobuo Nishi, Nayu Ikeda","doi":"10.1038/s41440-026-02745-y","DOIUrl":"https://doi.org/10.1038/s41440-026-02745-y","url":null,"abstract":"<p><p>In this scoping review, we aimed to identify existing salt-reduction guidance for the food industry to support food companies seeking to reduce salt levels in their products. The search was conducted on PubMed and Google by two investigators. We extracted the common characteristics of the guidance. Of the 387 websites and 20 pieces of literature reviewed, four guidance documents were identified. All the extracted guidance documents included the background of the guidance development, current sodium intake, and target amounts. The background of the development of these guidance documents in various countries included reports that excessive salt intake increases the risk of diseases and healthcare costs, and that educational initiatives alone have limited effectiveness in reducing salt intake. Sodium intake exceeded the targets in most regions, largely due to processed foods. Of the four guidance documents, three were published by government agencies and one by the food industry. Three documents (Canada, the United States, and the United Kingdom) primarily function as category-specific sodium reduction target frameworks for industry, whereas the European document developed by FoodDrinkEurope provides more practice-oriented guidance focusing on reformulation strategies. The target intake levels were set at 5.1-7.0 g/day, with timelines spanning 3-5 years. This review may serve as a reference for the food industry in countries with excessive salt intake to facilitate the development of strategies for reducing salt consumption.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080228","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 between peripheral blood eosinophil count and kidney replacement therapy initiation risk in patients with nephrosclerosis.","authors":"Haruki Mae, Go Kanzaki, Hiroki Nobayashi, Hideaki Kuno, Rina Oba, Hirokazu Marumoto, Kotaro Haruhara, Yudo Tanno, Keita Hirano, Masato Ikeda, Nobuo Tsuboi, Takashi Yokoo","doi":"10.1038/s41440-026-02818-y","DOIUrl":"https://doi.org/10.1038/s41440-026-02818-y","url":null,"abstract":"<p><p>Eosinophils are implicated in cardiovascular risk and chronic kidney disease progression. However, prior cohorts included patients with heterogeneous etiologies, making it unclear whether eosinophils independently predict kidney prognosis in nephrosclerosis, a condition characterized by vascular injury. Therefore, we investigated whether the peripheral eosinophil count is associated with kidney prognosis in patients with biopsy-proven nephrosclerosis. This retrospective multicenter cohort study included 202 patients with biopsy-proven nephrosclerosis who underwent kidney biopsy between 2010 and 2024. Patients were categorized into low and high eosinophil groups according to the median peripheral eosinophil count. The primary outcome was kidney replacement therapy initiation. Missing data were handled using multiple imputations with chained equations. Multivariable Cox proportional hazards models were used to assess associations, and Least Absolute Shrinkage and Selection Operator regression was applied to identify relevant covariates. Sensitivity analyses treated eosinophil count as a continuous variable. During a median follow-up of 28.5 months, kidney replacement therapy was initiated in 31 patients (15.3%). The high eosinophil group had a significantly higher incidence of kidney replacement therapy initiation (p = .005) and demonstrated an independent association with increased risk in multivariable analysis (hazard ratio 3.09; 95% confidence interval 1.06-8.95). This association remained significant in sensitivity analyses, treating eosinophil count as a continuous variable (hazard ratio per standard deviation increase 1.47; 95% confidence interval 1.01-2.14). Elevated peripheral eosinophil counts were independently associated with adverse kidney outcomes in patients with nephrosclerosis, suggesting their potential prognostic value.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080241","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}