Hypertension Research最新文献

{"title":"Serial ambulatory blood pressure changes after renal denervation in a young patient with resistant hypertension.","authors":"Tatsuya Mizoguchi, Masashi Yokoi, Tsuyoshi Ito, Yoshihiro Seo","doi":"10.1038/s41440-026-02820-4","DOIUrl":"https://doi.org/10.1038/s41440-026-02820-4","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069576","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":"Individual income and blood pressure control after antihypertensive treatment initiation accounting for regional variation: a Japanese nationwide study.","authors":"Michihiro Satoh, Yutaro Iwabe, Kosuke Inoue, Hiroki Nobayashi, Seiya Izumi, Takahisa Murakami, Maya Toyama, Yuya Suzuki, Tomoko Muroya, Shingo Nakayama, Takayoshi Ohkubo, Hirohito Metoki","doi":"10.1038/s41440-026-02813-3","DOIUrl":"https://doi.org/10.1038/s41440-026-02813-3","url":null,"abstract":"<p><p>Evidence on how individual-level socioeconomic status and regional disparities jointly influence BP control after treatment initiation remains scarce. We assessed the association between income and uncontrolled BP after antihypertensive treatment initiation and examined regional variation in Japan. We conducted a cohort study using health checkup data from the Japan Health Insurance Association (2015-2022). Participants were adults aged 40-74 years who had initiated antihypertensive treatment. Income was categorized into sex-specific quintiles based on standard monthly remuneration. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for uncontrolled BP (systolic/diastolic BP ≥ 130/ ≥ 80 mmHg). We included 381 116 females and 933 876 males (mean age, 55 years). Uncontrolled BP was observed in 68.4% of females and 75.3% of males. After adjustment for covariates, the lowest income category had higher odds of uncontrolled BP than the highest category (female, OR [95% CI], 1.48 [1.45-1.51]; male, OR [95% CI], 1.26 [1.24-1.28]). This association was attenuated after adjustment for pretreatment systolic BP. Prefecture difference contributed more to model fit than income category, as evidenced by larger Akaike information criterion (AIC) increases upon removal from the fully adjusted model (ΔAIC: 551 vs 255 in females, 1433 vs. 293 in males). The income effect on uncontrolled BP remained even within each prefecture, with low-to-moderate between-prefecture heterogeneity (I² ≤ 47.7%). Lower income was associated with uncontrolled BP. This association was attenuated after adjustment for pretreatment BP, suggesting that delayed detection or treatment initiation partly explains this disparity. Meanwhile, geographic variation across prefectures remained substantial.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074483","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":"Agreement between seven-day and fourteen-day home systolic blood pressure stability scores: A J-HOP study analysis.","authors":"Kazuomi Kario, Hiroshi Kanegae, Yukie Okawara, Thilo Burkard, Satoshi Hoshide","doi":"10.1038/s41440-026-02800-8","DOIUrl":"https://doi.org/10.1038/s41440-026-02800-8","url":null,"abstract":"<p><p>This study investigated agreement between a score derived from guideline-consistent 7-day home BP monitoring (HBPM) and the score previously derived from 14-day monitoring (which was shown to be associated with cardiovascular prognosis). This was a secondary analysis of the home SBP stability score study using data from the Japan Morning Surge-Home Blood Pressure (J-HOP) study. The home SBP stability score (0-10 points) was calculated based on morning-evening average home SBP, average real variability, average peak home SBP, and time in therapeutic range. Scores were calculated for 14 days (days 1-14), the first week (days 1-7), and the second week (days 8-14). Agreement between scores was evaluated using Spearman's rank correlation coefficients and weighted kappa statistics. Of 4310 J-HOP participants, 3353 were included in this analysis (age 65.0 ± 10.4 years, 45.8% male). Mean home SBP stability scores were similar across the 14-day, first week and second week: 6.2 ± 2.9, 6.2 ± 2.9 and 6.3 ± 2.9 points, respectively. Agreement between the 14-day score and both the first-week (Spearman's correlation coefficient: 0.935 [95% confidence interval (CI) 0.931-0.939]; weighted kappa 0.799 [95% CI 0.790-0.809]) and second-week (Spearman's correlation coefficient 0.894 [95% CI 0.887-0.901]; weighted kappa 0.739 [95% CI 0.728-0.749]) scores was high; agreement between the first-week and second-week scores was lower. These findings support the feasibility of calculating the home SBP stability score from standardized, guideline-recommended 1-week HBPM data in clinical practice. However, week-to-week agreement was moderate, suggesting that short-term classification variability at the individual level should be considered.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060514","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":"Silent brain infarction is associated with executive dysfunction in community-dwelling older adults: the Sefuri-Yoshinogari study.","authors":"Hiroshi Yao, Kenji Fukuda, Manabu Hashimoto, Yasushi Okada, Tetsuro Ago","doi":"10.1038/s41440-026-02811-5","DOIUrl":"https://doi.org/10.1038/s41440-026-02811-5","url":null,"abstract":"<p><p>The most representative form of cognitive impairment in vascular cognitive impairment (VCI) is executive dysfunction caused by cerebral small vessel disease (CSVD). The aim of the present study is to investigate the effects of CSVD, particularly silent brain infarction (SBI), on executive function. We performed a cross-sectional observational study of 652 community-dwelling older adults (mean age, 69.7 years), who were independent in their daily activities and had no apparent dementia. All participants underwent the Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA), the modified Stroop test (Model 1: cut-off values according to our previous study, and Model 2: the total score above the fifth quintile for each given decade), and apathy scale. Imaging was performed using a 1.5 T MRI scanner for CSVD evaluation and the Voxel-based Specific Regional analysis system for Alzheimer's Disease (VSRAD). SBI was detected in 65 of the 652 participants (10.0%). Logistic regression analysis revealed that cognitive dysfunction defined by MMSE or MoCA was primarily associated with hippocampal atrophy, whereas executive dysfunction was associated with SBI in Model 1 (OR, 2.392, 95% CI, 1.215-4.708) and in Model 2 (OR, 2.040, 95% CI, 1.157-3.598). Executive dysfunction, defined by prolonged performance on the modified Stroop test, was associated with SBI (i.e., VCI caused by CSVD), in addition to age. The future study should address the possibility that VCI or CSVD-related cognitive decline could be prevented by controlling vascular risk factors. Graphical abstract: Community-dwelling older adults without dementia underwent brain MRI. A total of 652 consecutive volunteers with a mean age of 69.7 years and a mean educational level of 12.2 years were included in the study. All participants underwent the MMSE or MoCA for the assessment of global cognition and the modified Stroop test for the assessment of executive function. Performance on the cognitive screening tests was associated with hippocampal atrophy, suggesting underlying AD pathology. Executive dysfunction, as indicated by prolonged performance on the modified Stroop test, was associated with age and SBI.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038260","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 current heated tobacco product use and incident hypertension: A nationwide real-world cohort study.","authors":"Koichiro Matsumura, Takahiro Tabuchi, Hironori Imano, Shohei Hakozaki, Masafumi Ueno, Hidekazu Tanaka, Gaku Nakazawa","doi":"10.1038/s41440-026-02817-z","DOIUrl":"https://doi.org/10.1038/s41440-026-02817-z","url":null,"abstract":"<p><p>The cardiovascular effects of heated tobacco products (HTPs) remain controversial. Here, we investigated the association between smoking status, including current HTP use, and incident hypertension using a large Japanese real-world database. This study used the DeSC database, which integrates health check-up records, claims data, lifestyle questionnaires, and mHealth application information. Participants who completed a detailed smoking questionnaire between 2021 and 2025 and had no hypertension at baseline were included. Participants were classified into five groups: never-smokers, current HTP users, current cigarette smokers, dual users, and former smokers. Inverse probability of treatment weighting (IPTW) was applied to balance the baseline characteristics. The primary outcome was incident hypertension during follow-up, defined as elevated blood pressure measurements at follow-up or the initiation of antihypertensive medication. Among 30,979 participants (mean age, 46.8 ± 9.8 years; 37.0% female), incident hypertension occurred in 5.1% of never-smokers, 8.2% of current HTP users, 9.3% of current cigarette smokers, 8.2% of dual users, and 9.0% of former smokers. Compared with never-smokers, IPTW-weighted modified Poisson regression demonstrated significantly increased risks of hypertension among current HTP users (relative risk [RR], 1.23; 95% confidence interval [CI], 1.01-1.50), current cigarette smokers (RR, 1.28; 95% CI, 1.05-1.57), dual users (RR, 1.47; 95% CI, 1.08-2.01), and former smokers (RR, 1.17; 95% CI, 1.05-1.30). Current HTP users had a higher risk of incident hypertension than never-smokers. These findings demonstrate an association between current HTP use and incident hypertension but do not establish a causal effect of HTP exposure.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038324","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":"Coumarins in hypertension management: from vascular signaling pathways to clinical perspectives.","authors":"Yasser Fakri Mustafa","doi":"10.1038/s41440-026-02810-6","DOIUrl":"https://doi.org/10.1038/s41440-026-02810-6","url":null,"abstract":"<p><p>Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality worldwide. Beyond conventional pharmacotherapy, growing interest has focused on bioactive natural compounds with vascular-protective properties. Coumarins, a diverse class of plant-derived benzopyrones, have emerged as potential modulators of blood pressure through their effects on endothelial function, oxidative stress, inflammation, and vascular remodeling. This review aimed to critically synthesize current evidence on the role of coumarins in hypertension management, integrating mechanistic insights, preclinical findings, pharmacokinetic considerations, and available clinical data. A structured analysis of experimental and clinical literature was conducted, emphasizing vascular signaling pathways implicated in hypertension. Data from in vitro studies, animal models of elevated blood pressure, observational cohorts, and randomized interventions were evaluated, with particular attention to nitric oxide bioavailability, reactive oxygen species modulation, inflammatory cytokine regulation, smooth muscle cell proliferation, and autonomic control mechanisms. Preclinical studies consistently demonstrate that several coumarin derivatives enhance endothelial-dependent vasodilation, restore nitric oxide signaling, reduce oxidative stress via NADPH oxidase inhibition, attenuate pro-inflammatory cytokine expression, and limit vascular smooth muscle cell proliferation. In hypertensive animal models, these effects translate into improved baroreflex sensitivity and reduced blood pressure. Observational studies and limited clinical trials suggest an inverse association between dietary coumarin intake and blood pressure levels; however, randomized evidence remains scarce and occasionally inconclusive. Coumarins exhibit multifaceted vascular-protective properties that support their potential as adjunctive agents in hypertension management. While mechanistic and preclinical data are compelling, robust, well-designed clinical trials are required to clarify efficacy, safety, optimal dosing, and patient stratification strategies before definitive therapeutic recommendations can be made.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982587","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":"Metabolic syndrome severity and the effects of intensive blood pressure lowering: Results from the STEP randomized trial.","authors":"Jiajia Zhao, Xilan Dong, Qirui Song, Jun Cai","doi":"10.1038/s41440-026-02754-x","DOIUrl":"10.1038/s41440-026-02754-x","url":null,"abstract":"<p><p>Several clinical trials have shown that intensive systolic blood pressure (SBP) lowering confers cardiovascular benefits. However, whether baseline metabolic syndrome (MetS) severity modifies these benefits and risks remains unclear. This post hoc analysis of the STEP trial included 8231 participants with complete MetS severity data. Baseline MetS severity was quantified using an age-, sex-, and ethnicity-specific MetS scoring model and analyzed as tertiles and continuously. The primary outcome was a composite of stroke, acute coronary syndrome, acute decompensated heart failure, coronary revascularization, atrial fibrillation, and cardiovascular death. Cox models and restricted cubic spline analyses were used to assess treatment-effect heterogeneity. During a median follow-up of 3.32 years, intensive SBP lowering reduced the risk of the primary outcome compared with standard treatment. The absolute incidence of the primary outcome and major adverse cardiac events was highest in the highest MetS tertile. Across MetS tertiles, event rates were lower in the intensive-treatment group, with the largest reduction in the middle tertile for the primary outcome (Q2: HR, 0.66; 95% CI, 0.44-0.99). No significant treatment-by-MetS interaction was observed in tertile-based or spline analyses. For safety outcomes, no significant treatment-by-MetS tertile interaction was observed, although hypotension was numerically more frequent with intensive treatment among participants in the highest MetS tertile. These findings suggest that baseline MetS severity identifies patients with higher absolute cardiovascular risk but does not significantly modify the relative efficacy of intensive SBP lowering. Careful monitoring for treatment-related hypotension may be warranted, particularly among patients with higher metabolic burden.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982602","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":"Beyond cardiovascular risk: integrating kidney health into the life-course approach to hypertensive disorders of pregnancy.","authors":"Juan Pablo Flores Serrano","doi":"10.1038/s41440-026-02809-z","DOIUrl":"https://doi.org/10.1038/s41440-026-02809-z","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982516","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":"Exercise for prevention and treatment of hypertension.","authors":"Ryo Naito","doi":"10.1038/s41440-026-02808-0","DOIUrl":"https://doi.org/10.1038/s41440-026-02808-0","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968201","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":"Low body mass index is not necessarily low cardiovascular risk in hypertension.","authors":"Takashi Hisamatsu","doi":"10.1038/s41440-026-02807-1","DOIUrl":"https://doi.org/10.1038/s41440-026-02807-1","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944796","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}