Hypertension Research最新文献

{"title":"Blood pressure variability in atrial fibrillation: separating prognostic signal from measurement noise.","authors":"Anastasios Kollias, Eirini-Chrysovalanti Antonogiannaki, Thomas Tsaganos, George S Stergiou","doi":"10.1038/s41440-026-02806-2","DOIUrl":"https://doi.org/10.1038/s41440-026-02806-2","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":"148944669","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":"For better blood pressure control in Asia.","authors":"Yuan-Yuan Kang, Ji-Guang Wang","doi":"10.1038/s41440-026-02804-4","DOIUrl":"https://doi.org/10.1038/s41440-026-02804-4","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":"148944806","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":"Adipocyte-specific deletion of adrenomedullin exacerbates high-fat diet-induced hypertension.","authors":"Miku Oya, Kosai Cho, Hideaki Inazumi, Toshio Nishikimi, Koichiro Kuwahara, Naoto Minamino, Yasuaki Nakagawa, Hideyuki Kinoshita, Kenji Moriuchi, Hiromu Yanagisawa, Takahiko Kanamori, Takeya Minami, Eiichiro Nishi, Kenji Kangawa, Kazuwa Nakao, Koh Ono","doi":"10.1038/s41440-026-02795-2","DOIUrl":"10.1038/s41440-026-02795-2","url":null,"abstract":"<p><p>Adrenomedullin (AM) is highly expressed in cardiovascular tissues and has been extensively studied as a vasoactive peptide. Subsequent studies have also demonstrated substantial AM expression in adipose tissue; however, the pathophysiological role of adipocyte-derived AM in obesity remains unclear. We generated adipocyte-specific AM knockout mice (Adiponectin-Cre; Adm^fl/fl, cKO) and fed cKO and littermate controls normal chow (NC) or HFD from 8 to 36 weeks of age. HFD increased systolic blood pressure (SBP) in both genotypes, but SBP was higher in cKO mice under chronic HFD conditions, despite no genotype-dependent difference in body weight. Circulating AM increased with HFD in both groups but remained lower in cKO mice. Plasma renin concentration did not differ by diet or genotype, whereas aldosterone increased with HFD without significant genotype-dependent differences. Urinary epinephrine and norepinephrine were unchanged, whereas an HFD-associated increase in urinary dopamine observed in controls was attenuated in cKO mice. Together, these data suggest that adipocyte-derived AM mitigates HFD-associated hypertension and may be linked to renal dopaminergic responses during chronic metabolic stress.</p>","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":"148944708","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":"Diet-induced obesity impairs salt-dependent downregulation of NCC activity.","authors":"Chiharu Kondo, Kohei Ueda, Tatsuo Shimosawa, Kaoruko Iida","doi":"10.1038/s41440-026-02798-z","DOIUrl":"10.1038/s41440-026-02798-z","url":null,"abstract":"<p><p>Obesity is associated with increased salt sensitivity and hypertension, but the mechanisms underlying altered renal sodium handling remain unclear. The Na-Cl cotransporter (NCC) is a key regulator of sodium reabsorption in the distal convoluted tubule and is dynamically regulated in response to changes in electrolyte balance. This study investigated whether diet-induced obesity (DIO) alters NCC responsiveness to salt loading in vivo and explored the underlying mechanisms using an ex vivo kidney slice model. Male C57BL/6 J mice were fed either a control or a high-fat (HF) diet for 22 weeks, followed by 2 weeks of NaCl loading. HF-fed mice developed obesity, hyperglycemia, hyperinsulinemia, and elevated systolic blood pressure. Although NaCl loading increased urinary sodium excretion and decreased serum aldosterone in both control and obese mice, the increase in urinary sodium excretion was attenuated in obese mice, suggesting enhanced renal sodium reabsorption. In addition, NaCl loading reduced NCC phosphorylation in control mice, whereas this response was attenuated in DIO mice, with no change in total NCC expression. Notably, STE20/SPS1-related proline-alanine-rich protein kinase (SPAK) phosphorylation was not significantly different among groups. In ex vivo kidney slice experiments, high-concentration insulin attenuated the high-potassium-induced suppression of NCC phosphorylation, whereas high glucose had no effect. These findings suggest that DIO impairs the normal suppression of NCC activity in response to salt loading without affecting basal NCC expression. Ex vivo findings suggest that insulin may modulate NCC responsiveness, although whether this mechanism contributes to NCC regulation in vivo remains uncertain. Impaired NCC responsiveness may promote renal sodium retention and could represent one potential mechanism linking obesity to altered sodium handling and blood pressure regulation.</p>","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":"148944776","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 the office and ambulatory blood pressure control in patients treated with two dual antihypertensive therapies.","authors":"Xiao-Fei Ye, Qi-Fang Huang, Xin-Yu Wang, Jia-Bo Zhu, Yi Zhou, Wen-Yuan-Yue Wang, Chang-Sheng Sheng, Yan Li, Ji-Guang Wang","doi":"10.1038/s41440-026-02791-6","DOIUrl":"https://doi.org/10.1038/s41440-026-02791-6","url":null,"abstract":"<p><p>We investigated seasonal variation in the office and ambulatory blood pressure control in hypertensive patients treated with two single-pill dual-combination antihypertensive therapies. The study participants (n = 560) were hypertensive patients enrolled in a 24-week therapeutic study. Antihypertensive treatment was initiated with amlodipine/benazepril 5/10 mg/day or benazepril/hydrochlorothiazide 10/12.5 mg/day, with the possible up-titration to 10/20 mg/day or 20/25 mg/day during follow-up, respectively. Office blood pressure was measured at each clinic visit, and ambulatory blood pressure monitoring was performed at baseline and 24-week follow-up. At 24 weeks of follow-up, in patients who continued antihypertensive treatment (n = 511), the proportion of up-titration to higher dosages was significantly different across seasons of treatment commencement in the benazepril/hydrochlorothiazide group (P = 0.002), but not in the amlodipine/benazepril group (P = 0.84). The between-group difference was significantly different in 134 patients who commenced treatment in winter (18.9% vs. 5.0%, P = 0.02), but not in 377 patients who commenced treatment in the other seasons (P ≥ 0.33). The control rate of office blood pressure (<140/90 mmHg) was significantly different across seasons of treatment commencement in the amlodipine/benazepril group (P = 0.01), but not in the benazepril/hydrochlorothiazide group (P = 0.16). The mean changes from baseline to 24-week follow-up tended to be smaller in the benazepril/hydrochlorothiazide than amlodipine/benazepril group in 24-h (mean between-group difference, -2.8 mmHg) and daytime diastolic blood pressure (mean between-group difference, -3.2 mmHg) in patients who commenced treatment in winter, though statistical significance was not achieved (P ≥ 0.07). In conclusion, there was seasonality in the clinic and ambulatory blood pressure-lowering effect of antihypertensive drug combinations, with a marginally significant difference in treatment intensity and blood pressure control between treatment with amlodipine or hydrochlorothiazide in combination with benazepril.</p>","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":"148944811","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":"Ambulatory blood pressure is higher in smokers than in nonsmokers: a systematic review and meta-analysis of observational studies.","authors":"Kimika Arakawa, Atsushi Sakima, Mai Kabayama, Ken Sugimoto, Yuichi Akasaki, Ako Fukami, Satoko Sakata, Hirochika Ryuno, Hiroyuki Kadoya, Toshiya Yamamoto, Yuya Akagi, Hiroko Yoshida, Yoichi Nozato, Taisuke Ueno, Makiko Abe, Hisatomi Arima, Mitsuru Ohishi, Nobuhito Hirawa, Chisa Matsumoto, Shin-Ichiro Miura, Masaki Mogi, Akira Nishiyama, Akihiro Nomura, Takayoshi Ohkubo, Yusuke Ohya, Shigeru Shibata, Yasuharu Tabara, Koichi Yamamoto, Kazuomi Kario","doi":"10.1038/s41440-026-02796-1","DOIUrl":"https://doi.org/10.1038/s41440-026-02796-1","url":null,"abstract":"<p><p>Findings regarding the association of smoking with office blood pressure (BP) have been inconsistent, and its relationship with out-of-office BP remains unclear. Therefore, we aimed to perform a systematic review and meta-analysis to evaluate this association. Eligible non-randomized comparative studies were identified through searches of PubMed and Ichushi-Web through September 2025. Nineteen cross-sectional studies that evaluated ambulatory BP met the eligibility criteria. Mean differences (MDs, smokers minus nonsmokers) and 95% confidence intervals (CIs) were pooled using random-effects models. Smokers had significantly higher 24-h (MD, 2.89 mmHg; 95% CI, 1.44-4.35) and daytime (MD, 2.85 mmHg; 95% CI, 1.47-4.23) ambulatory systolic BP (SBP). Smokers also had significantly higher 24-h (MD, 1.87 mmHg; 95% CI, 0.73-3.00) and daytime (MD, 1.25 mmHg; 95% CI, 0.00-2.50) ambulatory diastolic BP (DBP). However, nighttime ambulatory SBP and DBP did not differ significantly between the groups. Smokers had significantly higher 24-h (MD, 5.17 bpm; 95% CI, 3.14-7.21), daytime (MD, 6.75 bpm; 95% CI, 4.83-8.67), and nighttime (MD, 4.09 bpm; 95% CI, 2.81-5.38) heart rates. Subgroup analyses showed greater differences in 24-h and daytime ambulatory SBP in studies including participants with hypertension (HT) than in those without HT (P for interaction = 0.006 and <0.001, respectively). These findings suggest that smoking is associated with an unfavorable ambulatory BP profile and may represent a barrier to BP control and HT management, underscoring the importance of smoking avoidance and cessation. Smokers had higher daytime ambulatory systolic blood pressure and 24-h heart rate than nonsmokers, suggesting an unfavorable ambulatory blood pressure profile. Smoking may represent a barrier to blood pressure control and hypertension management, underscoring the importance of smoking avoidance and cessation.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929783","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":"Home blood pressure variability and risk of cardiovascular outcomes in elderly patients with non-valvular atrial fibrillation from the ANAFIE registry.","authors":"Daisuke Yoshida, Keisuke Shinohara, Shota Ikeda, Masayuki Hirose, Junji Kishimoto, Hirotsugu Atarashi, Takeshi Yamashita, Shinya Suzuki, Hiroaki Kobayashi, Hiroyuki Tsutsui, Kohtaro Abe","doi":"10.1038/s41440-026-02778-3","DOIUrl":"10.1038/s41440-026-02778-3","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is frequently accompanied by hypertension; however, the relationship between mid-term blood pressure variability (BPV) assessed using home blood pressure (BP) measurements and prognosis in patients with AF remains unclear. We examined the association between home BPV and cardiovascular outcomes in elderly patients with non-valvular AF using data from the ANAFIE (All Nippon AF In the Elderly) Registry. This post hoc analysis of a prospective registry included 4885 patients aged ≥75 years who performed standardized home BP measurements in the morning and evening (two measurements at each time point) over seven consecutive days. Mid-term BPV was quantified using the coefficient of variation of systolic home BP and categorized into quartiles. The primary endpoint was a net cardiovascular outcome, defined as a composite of stroke, systemic embolism, and major bleeding. Associations were assessed using multivariable Cox proportional hazards models adjusted for mean BP and established risk factors. Over a median follow-up of two years, the net cardiovascular outcome occurred in 171 patients. Compared with the lowest BPV quartile, patients in the highest quartile had a significantly higher risk of the net cardiovascular outcome (HR 2.03, 95% CI 1.21-3.40). Higher risks were also observed for stroke/systemic embolism, intracranial hemorrhage, and bleeding. Findings were consistent when BPV was assessed using the standard deviation and across subgroups. In conclusion, greater mid-term home BPV was independently associated with increased cardiovascular risk beyond average BP in elderly patients with non-valvular AF.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929796","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":"Blood pressure and cardiovascular risk in adults with non-proteinuric chronic kidney disease without diabetes.","authors":"Yuta Suzuki, Masachika Nishikawa, Hidehiro Kaneko, Akira Okada, Toshiyuki Ko, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Naoki Nakagawa, Tatsuhiko Azegami, Kaori Hayashi, Takashi Yokoo, Koichi Node, Hideo Yasunaga, Norihiko Takeda","doi":"10.1038/s41440-026-02801-7","DOIUrl":"https://doi.org/10.1038/s41440-026-02801-7","url":null,"abstract":"<p><p>We investigated the association between blood pressure (BP) and the risk of cardiovascular disease (CVD) in individuals with non-proteinuric chronic kidney disease (CKD) without diabetes. Using a large-scale nationwide administrative claims and health checkup database in Japan, we identified 287,238 non-diabetic adults with an estimated glomerular filtration rate <60 mL/min/1.73 m² and negative/trace proteinuria. We examined the association between BP and CVD events by modeling BP both as a continuous variable and as a categorical variable according to the 2017 ACC/AHA guideline classification. The primary outcome was a composite of myocardial infarction, stroke, heart failure, and atrial fibrillation. Multivariable Cox regression analyses showed that higher systolic BP (SBP) was associated with increased CVD risk (hazard ratio [HR] 1.05 per 10 mmHg; 95% CI 1.04-1.05). Compared with normal BP, the HRs were 1.03 (95% CI 1.00-1.07) for elevated BP, 1.08 (1.05-1.11) for stage 1 hypertension, and 1.20 (1.17-1.24) for stage 2 hypertension. Restricted cubic spline analysis showed an increase in CVD risk at SBP levels above ~130 mmHg. However, among individuals receiving antihypertensive medication, a U-shaped association was observed, with an increased risk also evident at SBP levels below ~130 mmHg. In individuals with non-proteinuric CKD without diabetes, higher SBP was positively associated with increased cardiovascular risk. However, a U-shaped association observed among individuals receiving antihypertensive treatment suggests that the relationship between BP and cardiovascular risk may be complex in this population, highlighting the potential importance of individualized clinical assessment.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929731","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":"Effects of sodium reduction interventions on home and morning home blood pressure: a systematic review and meta-analysis of randomized controlled trials.","authors":"Atsushi Sakima, Hisatomi Arima, Kimika Arakawa, Daigoro Hirohama, Kento Kitada, Einosuke Mizuta, Sayaka Nagata, Hiroki Nakano, Sayoko Ogura, Kensuke Sasaki, Jun Suzuki, Hiroyuki Takase, Kohei Ueda, Makiko Abe, Takashi Hisamatsu, Yukari Takemi, Nobuhito Hirawa, Chisa Matsumoto, Shin-Ichiro Miura, Masaki Mogi, Akira Nishiyama, Akihiro Nomura, Takayoshi Ohkubo, Yusuke Ohya, Shigeru Shibata, Yasuharu Tabara, Koichi Yamamoto, Kazuomi Kario, Katsuyuki Miura","doi":"10.1038/s41440-026-02794-3","DOIUrl":"https://doi.org/10.1038/s41440-026-02794-3","url":null,"abstract":"<p><p>Excessive sodium chloride (salt) intake significantly contributes to hypertension and cardiovascular diseases, and reducing sodium is a cornerstone of non-pharmacological management of hypertension. Although the antihypertensive effects of sodium reduction are well established, most existing evidence is from office blood pressure (BP) measurements, with limited data available on home BP. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effects of sodium reduction on home BP. We searched PubMed and the Cochrane Library from inception to September 2025 and included 23 RCTs comprising 4110 participants. Sodium reduction significantly reduced home systolic BP (SBP) (mean difference [MD], -3.66 mmHg; 95% confidence interval [CI], -4.86 to -2.45; P < 0.001) and home diastolic BP (MD, -1.40 mmHg; 95% CI, -2.08 to -0.71; P < 0.001). Nine studies that reported morning home BP also showed reduced morning home SBP (MD, -4.06 mmHg; 95% CI, -6.60 to -1.52; P = 0.002). Greater reductions in home SBP were observed in predominantly hypertensive populations than in non-hypertensive populations (P for heterogeneity = 0.003). No significant differences were detected across other predefined subgroups. Sodium reduction interventions were also associated with significant reductions in salt intake, urinary sodium excretion, and the urinary sodium-to-potassium ratio. Quantitative synthesis was not feasible because only a few included studies reported cardiovascular or adverse events. In conclusion, sodium reduction interventions effectively lower home BP, including morning home BP, with a greater impact in hypertensive populations. Thus, reducing sodium is a practical strategy for improving home BP control, particularly in hypertensive populations. This systematic review and meta-analysis of randomized controlled trials showed that sodium reduction interventions significantly lowered home systolic blood pressure (SBP), including morning SBP. No significant differences in BP-lowering effects were detected across various sodium reduction strategies, and digital health approaches may support implementation and adherence. Sodium reduction interventions were also associated with reductions in salt intake, urinary sodium excretion, and the urinary sodium-to-potassium ratio. These findings support major hypertension guidelines, including the Japanese Society of Hypertension Guidelines for managing elevated blood pressure and hypertension 2025 (JSH2025) and the JSH Morning Hypertension Eradication Program Project (Asakatsu BP Action Plan-the Morning Blood Pressure 130 Campaign).</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919855","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 office blood pressure: J-SAMIT and the emerging era of implementation hypertension.","authors":"Naoki Nakagawa","doi":"10.1038/s41440-026-02805-3","DOIUrl":"https://doi.org/10.1038/s41440-026-02805-3","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919765","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}