Hypertension Research最新文献

{"title":"Blood pressure at hospital admission: a window into the prognoses of patients with atrial fibrillation.","authors":"Takahiro Okumura, Satoshi Yanagisawa, Toyoaki Murohara","doi":"10.1038/s41440-025-02196-x","DOIUrl":"10.1038/s41440-025-02196-x","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709757","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":"Microstructural damage and lower myelin content in the Brainstem associated with hypertension.","authors":"Joji Ishikawa","doi":"10.1038/s41440-025-02184-1","DOIUrl":"https://doi.org/10.1038/s41440-025-02184-1","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718695","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":"Is lenvatinib-induced blood pressure elevation a favorable prognostic factor in patients with hepatocellular carcinoma?","authors":"Satoshi Kidoguchi","doi":"10.1038/s41440-025-02197-w","DOIUrl":"10.1038/s41440-025-02197-w","url":null,"abstract":"<p><p>Lenvatinib, a multi-tyrosine kinase inhibitor approved for the treatment of multiple cancer types, can induce hypertension, which can be a prognostic indicator in patients with hepatocellular carcinoma. Further research into the mechanism of anticancer drug-induced blood pressure elevation is necessary and patients should be managed by a multi-disciplinary \"Onco-Hypertension\" team.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709766","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":"Real-world use of finerenone in patients with chronic kidney disease and type 2 diabetes based on large-scale clinical studies: FIDELIO-DKD and FIGARO-DKD.","authors":"Atsuhisa Sato, Mitsuhiro Nishimoto","doi":"10.1038/s41440-025-02175-2","DOIUrl":"10.1038/s41440-025-02175-2","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Finerenone is a new mineralocorticoid receptor antagonist that does not have a steroid skeleton, and in two large-scale clinical studies targeting patients with chronic kidney disease (CKD) complicated with type 2 diabetes (FIDELIO-DKD and FIGARO-DKD), it significantly reduced the composite endpoints due to the progression of renal disease, and the composite endpoints of cardiovascular disease. Recently, we published two databases summarizing how finerenone is used in clinical practice in Japan (FINEROD). In this paper, we examines how best to use finerenone to get the most out of its effects. The most important side effect of finerenone is hyperkalemia, and the risk of hyperkalemia increases as renal function declines. By starting treatment early when eGFR is maintained, it is expected that side effects will be reduced. Furthermore, the FIDELITY analysis (a pooled analysis of FIDELIO-DKD and FIGARO-DKD) has shown that the clinical effect is stronger when finerenone treatment is started at an early stage of CKD. The simultaneous use of RAS inhibitors (ACE inhibitor or ARB), finerenone, and SGLT2 inhibitors appears to be a promising treatment. Further, it is important to continue the medications of RAS inhibitors and MR antagonists as long as possible. To prevent hyperkalemia, the most reliable and safest method is to use a new oral potassium adsorbent. It is important to think of a new oral potassium adsorbent not as something that will lower serum potassium levels, but as something that will allow you to avoid discontinuing or increase the dose of RAS inhibitors or MR antagonists. Differences between steroidal and non-steroidal mineralocorticoid receptor (MR) antagonists. Mineralocorticoid receptors (MR) are present in epithelial tissues such as renal tubules and intestinal epithelium, as well as in non-epithelial tissues such as the brain, heart, and blood vessel walls. Although the MR itself is exactly the same in both tissues, its physiological actions are completely different. In epithelial tissues, cortisol is inactivated by the enzyme 11β-hydroxysteroid dehydrogenase type 2 (11 β-HSD2), and aldosterone selectively binds to the MR. On the other hand, in non-epithelial tissues, 11 β-HSD2 is almost nonexistent or is only weakly active, so that cortisol, which outnumbers it, binds to almost all the MR, and aldosterone binds to the very few remaining MR. Spironolactone, a representative MR antagonist with a steroid skeleton, has a high affinity for renal tubules, and concentrates there, where it is highly effective. Therefore, it is classified as a potassium-sparing diuretic. However, if it does not have a steroid skeleton, its affinity for epithelial and non-epithelial tissues is equal. In other words, its effect on epithelial tissues is relatively weak, and its effect on non-epithelial tissues is relatively strong. Finerenone does not cross the blood-brain barrier (BBB), and does not reach the central nervous system. The central MR, esp","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709775","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":"Uric acid and hypertension: insights from the joint symposium.","authors":"Masanari Kuwabara, Shigeru Shibata, Einosuke Mizuta, Atsushi Tanaka, Tatsuya Maruhashi, Ichiro Hisatome, Atsuhiro Ichihara, Takuya Tsuchihashi","doi":"10.1038/s41440-025-02192-1","DOIUrl":"https://doi.org/10.1038/s41440-025-02192-1","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676637","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 voices of elementary school students can change the rate of hypertension control in the community! ~One Healthy Wall Newspaper Moved Us~.","authors":"Tetsuro Yoshida","doi":"10.1038/s41440-025-02190-3","DOIUrl":"https://doi.org/10.1038/s41440-025-02190-3","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676614","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":"Sex differences in the relationship between obesity and hypertension in Japan: a large population-based cross-sectional study.","authors":"Tomomi Nagahata, Nagako Okuda, Kozo Tanno, Yuki Yonekura, Aya Higashiyama, Hirokazu Taniguchi, Koki Kosami, Akira Okayama","doi":"10.1038/s41440-025-02187-y","DOIUrl":"https://doi.org/10.1038/s41440-025-02187-y","url":null,"abstract":"<p><p>We examined the effect of sex on the relationship between obesity and hypertension among Japanese people, who generally have a lower prevalence of obesity than Westerners. We analyzed the results of specific health checkups for Japanese aged 40-74 years (688,306 men and 891,191 women) obtained in 2011. The participants were divided into four age groups (40-49, 50-59, 60-69, and 70-74 years) and five body mass index (BMI) categories (≤ 24.9 [non-overweight/obesity], 25.0-26.9 and 27.0-29.9 [overweight], 30.0-34.9 and ≥ 35.0 kg/m² [obesity]). The odds ratio for hypertension in each BMI category was calculated using normal weight as the reference. The prevalence of hypertension was 26.8%-65.5% for men and 17.6%-53.6% for women in the overweight or obesity categories in the 40-49 age group, and 72.0%-88.7% for men and 70.1%-90.6% for women in the 70-74 age group. In women aged 40-49, the prevalence of hypertension in each BMI category was approximately 10% lower than that in men, but there was almost no difference between men and women in the 70-74 age group. On the other hand, the odds ratio for hypertension was higher in women than in men across all BMI categories and age groups. A stronger relationship between obesity and hypertension was observed in women than in men in all age groups. Japanese women have not been the target of studies for obesity, but more attention should be paid to Japanese women with obesity.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663477","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":"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":"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":"Combination of medical therapy and percutaneous transluminal renal angioplasty versus medical therapy alone for patients with atherosclerotic renal artery stenosis: systematic review and meta-analysis.","authors":"Takeshi Fujiwara, Yoshio Iwashima, Keisuke Narita, Michihiro Satoh, Atsushi Sakima","doi":"10.1038/s41440-025-02166-3","DOIUrl":"https://doi.org/10.1038/s41440-025-02166-3","url":null,"abstract":"<p><p>We investigated whether the combination of medical therapy plus percutaneous transluminal renal angioplasty (PTRA) provides superior clinical outcomes compared to those afforded by medical therapy alone in patients with hypertension due to atherosclerotic renal artery stenosis (ARAS) by conducting a systematic review and meta-analysis of the relevant randomized controlled trials (RCTs). The evaluated outcomes included: (1) cardiovascular disease (CVD)-related mortality, (2) the incidence of CVD events, (3) changes in blood pressure (BP), (4) suppression of renal function decline, (5) changes in the number of antihypertensive drugs used, and (6) serious adverse events. Nine RCTs involving 2275 patients were analyzed, revealing that the combination therapy significantly reduced the number of antihypertensive drugs compared to medical therapy alone (mean difference: -0.42, 95% confidence interval: -0.71 to -0.12). However, there were no significant differences between the combination therapy and medical therapy alone in CVD mortality, the incidence of CVD events, BP changes, suppression of renal function decline, or serious adverse events. The included studies demonstrated a low-to-moderate risk of bias, with performance and detection bias being the most prominent concerns. Together our findings demonstrate that compared to medical therapy alone, the combination of medical therapy + PTRA reduced the number of antihypertensive drugs used but did not improve adverse CVD or renal outcomes. The quality of the included RCTs represents a potential limitation of this analysis.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556605","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}