Hypertension Research最新文献

{"title":"Liver biomarkers and preeclampsia: an easy-accessible prediction method of the disease","authors":"Katsuhiko Naruse","doi":"10.1038/s41440-024-01804-6","DOIUrl":"10.1038/s41440-024-01804-6","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41440-024-01804-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home blood pressure-lowering effect of a non-steroidal mineralocorticoid receptor blocker, esaxerenone, versus trichlormethiazide for uncontrolled hypertension: the EXCITE-HT randomized controlled study","authors":"Kazuomi Kario, Hiroyuki Ohbayashi, Masami Hashimoto, Naoki Itabashi, Mitsutoshi Kato, Kazuaki Uchiyama, Kunio Hirano, Noriko Nakamura, Takahide Miyamoto, Hirotaka Nagashima, Shizuo Kajiyama, Hidenori Ishida, Enyu Imai, Yusuke Ebe, Mitsuru Ohishi, Tomohiro Katsuya, Takashi Taguchi, Ayumi Tanabe, Tatsuo Shimosawa, on behalf of the EXCITE-HT investigators","doi":"10.1038/s41440-024-01762-z","DOIUrl":"10.1038/s41440-024-01762-z","url":null,"abstract":"The EXCITE-HT study aimed to evaluate the efficacy and safety of esaxerenone versus thiazide diuretics (trichlormethiazide) as second-line treatment for Japanese patients with uncontrolled essential hypertension. This was a 12-week, multicenter, randomized, open-label, parallel-group study. The non-inferiority of esaxerenone to trichlormethiazide was confirmed if the upper limit of the two-sided 95% confidence interval (CI) for the difference in systolic blood pressure (SBP)/diastolic blood pressure (DBP) change between groups was below 3.9/2.1 mmHg. A total of 295 and 290 patients were included in the esaxerenone and trichlormethiazide groups, respectively. The non-inferiority of esaxerenone to trichlormethiazide was demonstrated: least squares mean change differences in morning home SBP/DBP at end of treatment (EOT) were −2.2 (95% CI, −3.6, −0.8) mmHg for SBP/−0.6 (−1.4, 0.2) mmHg for DBP. Morning home, bedtime home, and office BP significantly decreased (all p < 0.001) from baseline to EOT in both groups. The urinary albumin-to-creatinine ratio and N-terminal pro-brain natriuretic peptide level decreased from baseline to Week 12 in both groups, with no notable intergroup difference. Serum potassium elevations occurred more frequently with esaxerenone, while serum potassium reductions occurred more with trichlormethiazide. Uric acid elevations were observed in both groups, but more frequently with trichlormethiazide than esaxerenone. No cases of gout occurred in this study. Reductions in estimated glomerular filtration rate were similarly observed in both groups. EXCITE-HT is the first randomized controlled study to demonstrate evidence that esaxerenone is non-inferior to trichlormethiazide as second-line treatment for Japanese patients with uncontrolled essential hypertension, with no new safety concerns. The EXCITE-HT study demonstrated the non-inferiority of esaxerenone to trichlormethiazide in its morning home blood pressure lowering effect and safety profile in Japanese patients with uncontrolled essential hypertension who were previously treated with an angiotensin II receptor blocker or calcium channel blocker.","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41440-024-01762-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal denervation alleviates vascular remodeling in spontaneously hypertensive rats by regulating perivascular adipose tissue.","authors":"Tingting Jiang, Yongkang Wei, Rui Xu, Yuanyuan Jin, Tingting Song, Huiying Wang, Wenjia Chen, Hui Tian, Lei Xu, Yong Zhao, Yu Fu","doi":"10.1038/s41440-024-01791-8","DOIUrl":"10.1038/s41440-024-01791-8","url":null,"abstract":"<p><p>Vascular remodeling is the main pathological process that causes the damage of the target organ of hypertension. Perivascular adipose tissue (PVAT) surrounds blood vessels and plays a key role in the pathogenesis of various cardiovascular diseases. This study aimed to investigate the effects of renal denervation (RDN) on hypertensive vascular remodeling and to elucidate the role of PVAT in this process. Male spontaneously hypertensive rat (SHR) and Wistar-Kyoto (WKY) rat were selected. Aortic vascular remodeling was evaluated using hematoxylin and eosin (H&E) staining and Masson's trichrome staining. Morphological changes in the PVAT were observed through H&E and Oil Red O staining. Dihydroethidium was used to measure oxidative stress levels in PVAT, while western blot analysis was used to determine the expression levels of proteins associated with vascular remodeling. The results showed that the aortic medial thickness, media thickness/lumen diameter, collagen volume fraction, and reactive oxygen species (ROS) level in PVAT were significantly higher in the SHR group than in the WKY group. The indexes mentioned above were lower in the SHR-RDN group than in the SHR group. H&E staining revealed that fat droplets in PVAT in the SHR-RDN group became smaller and browning occurred. Moreover, the protein expression of uncoupling protein-1 (UCP-1) and neuregulin 4 (Nrg4) was significantly increased in the SHR-RDN group. In addition, the expression of adiponectin increased and the expression of leptin decreased in the SHR-RDN group compared to the SHR group. In conclusion, RDN can relieve hypertensive vascular remodeling, which may be associated with PVAT.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751551","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":"Vasopressin and cardiovascular autonomic adjustment in chronic hypertensive pregnancy","authors":"Mirjana Jovanović,&nbsp;Bojana Stevanović,&nbsp;Vladislav Pajović,&nbsp;Tatjana Tasić,&nbsp;Maja Lozić,&nbsp;Ljiljana Đukić,&nbsp;Marija Kosić,&nbsp;David Murphy,&nbsp;Nina Japundžić-Žigon","doi":"10.1038/s41440-024-01769-6","DOIUrl":"10.1038/s41440-024-01769-6","url":null,"abstract":"Chronic hypertensive pregnancy (CHP) is a growing health issue with unknown etiology. Vasopressin (VP), a nonapeptide synthesized in paraventricular (PVN) and supraoptic nucleus (SON), is a well-known neuroendocrine and autonomic modulator of the cardiovascular system, related to hypertension development. We quantified gene expression of VP and its receptors, V1aR and V1bR, within the PVN and SON in CHP and normal pregnancy, and assessed levels of secreted plasma VP. Also, we evaluated autonomic cardiovascular adaptations to CHP using spectral indices of blood pressure (BPV) and heart rate (HRV) short-term variability, and spontaneous baroreflex sensitivity (BRS). Experiments were performed in female spontaneously hypertensive rats (SHRs) and in normotensive Wistar rats (WRs). Animals were equipped with a radiotelemetry probe for continuous hemodynamic recordings before and during pregnancy. BPV, HRV and BRS were assessed using spectral analysis and the sequence method, respectively. Plasma VP was determined by ELISA whilst VP, V1aR, and V1bR gene expression was analyzed by real-time-quantitative PCR (RT-qPCR). The results show that non-pregnant SHRs exhibit greater VP, V1aR, and V1bR gene expression in both PVN and SON respectively, compared to Wistar dams. Pregnancy decreased VP gene expression in the SON of SHRs but increased it in the PVN and SON of WRs. Pregnant SHRs exhibited a marked drop in plasma VP concentration associated with BP normalization. This triggered marked tachycardia, heart rate variability increase, and BRS increase in pregnant SHRs. It follows that regardless of BP normalization in late pregnancy, SHRs exhibit cardiovascular vulnerability and compensate by recruiting vagal mechanisms.","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41440-024-01769-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141742569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An outcome-driven threshold for pulse pressure amplification","authors":"Qi-Fang Huang,&nbsp;De-Wei An,&nbsp;Lucas S. Aparicio,&nbsp;Yi-Bang Cheng,&nbsp;Fang-Fei Wei,&nbsp;Yu-Ling Yu,&nbsp;Chang-Sheng Sheng,&nbsp;Wen-Yi Yang,&nbsp;Teemu J. Niiranen,&nbsp;José Boggia,&nbsp;Katarzyna Stolarz-Skrzypek,&nbsp;Valérie Tikhonoff,&nbsp;Natasza Gilis-Malinowska,&nbsp;Wiktoria Wojciechowska,&nbsp;Edoardo Casiglia,&nbsp;Krzysztof Narkiewicz,&nbsp;Jan Filipovský,&nbsp;Kalina Kawecka-Jaszcz,&nbsp;Tim S. Nawrot,&nbsp;Ji-Guang Wang,&nbsp;Yan Li,&nbsp;Jan A. Staessen,&nbsp;The International Database of Central Arterial Properties for Risk Stratification (IDCARS) Investigators","doi":"10.1038/s41440-024-01779-4","DOIUrl":"10.1038/s41440-024-01779-4","url":null,"abstract":"Pulse pressure amplification (PPA) is the brachial-to-aortic pulse pressure ratio and decreases with age and cardiovascular risk factors. This individual-participant meta-analysis of population studies aimed to define an outcome-driven threshold for PPA. Incidence rates and standardized multivariable-adjusted hazard ratios (HRs) of cardiovascular and coronary endpoints associated with PPA, as assessed by the SphygmoCor software, were evaluated in the International Database of Central Arterial Properties for Risk Stratification (n = 5608). Model refinement was assessed by the integrated discrimination (IDI) and net reclassification (NRI) improvement. Age ranged from 30 to 96 years (median 53.6). Over 4.1 years (median), 255 and 109 participants experienced a cardiovascular or coronary endpoint. In a randomly defined discovery subset of 3945 individuals, the rounded risk-carrying PPA thresholds converged at 1.3. The HRs for cardiovascular and coronary endpoints contrasting PPA &lt; 1.3 vs ≥1.3 were 1.54 (95% confidence interval [CI]: 1.00–2.36) and 2.45 (CI: 1.20–5.01), respectively. Models were well calibrated, findings were replicated in the remaining 1663 individuals analyzed as test dataset, and NRI was significant for both endpoints. The HRs associating cardiovascular and coronary endpoints per PPA threshold in individuals &lt;60 vs ≥60 years were 3.86 vs 1.19 and 6.21 vs 1.77, respectively. The proportion of high-risk women (PPA &lt; 1.3) was higher at younger age (&lt;60 vs ≥60 years: 67.7% vs 61.5%; P &lt; 0.001). In conclusion, over and beyond common risk factors, a brachial-to-central PP ratio of &lt;1.3 is a forerunner of cardiovascular coronary complications and is an underestimated risk factor in women aged 30–60 years. Our study supports pulse wave analysis for risk stratification.","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41440-024-01779-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141742570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy conditions and outcomes of Chinese women with mild, moderate and severe pulmonary arterial hypertension","authors":"Cong Fan,&nbsp;Xiaoyan Liu,&nbsp;Runyu Liu,&nbsp;Yuan Zhang,&nbsp;Panpan Hao","doi":"10.1038/s41440-024-01795-4","DOIUrl":"10.1038/s41440-024-01795-4","url":null,"abstract":"Pregnancy is normally contraindicated in pulmonary arterial hypertension (PAH). Thanks to medical advances, the prognosis for pregnancy in patients with PAH has improved. The aim of our study was to investigate pregnancy conditions and outcomes in patients with mild, moderate and severe PAH. We searched PubMed, Embase, CNKI, Wanfang and Weipu databases for studies published before May 2024. Data from 29 included studies from 1898 references were pooled and analyzed. We calculated the rates for each group as well as the risk ratio (RR) and 95% confidence interval (CI) between pairwise. There was no statistical difference in maternal and neonatal survival between the mild and moderate groups. Maternal survival in the mild, moderate and severe groups was 100.0%, 99.7% and 88.8%, respectively, and neonatal survival was 100.0%, 99.7% and 96.0%, respectively. The incidence of NYHA class III-IV, pregnancy loss, intensive care unit (ICU) admission, fetal growth restriction, and neonatal asphyxia was lowest in patients with mild PAH and highest in patients with severe PAH (P &lt; 0.001). The incidence of vaginal deliveries and term pregnancies was highest in the mild group and lowest in the severe group (P &lt; 0.001). In conclusion, pregnant women with mild PAH can safely deliver a newborn. Given similar survival rates but greater economic and medical burdens, caution is advised in the moderate group. Pregnancy in the severe group is considered contraindicated.","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626561","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":"Sodium excretion per nephron and nighttime hypertension in patients with IgA nephropathy","authors":"Hirokazu Marumoto,&nbsp;Nobuo Tsuboi,&nbsp;Takaya Sasaki,&nbsp;Yusuke Okabayashi,&nbsp;Kotaro Haruhara,&nbsp;Go Kanzaki,&nbsp;Kentaro Koike,&nbsp;Takashi Yokoo","doi":"10.1038/s41440-024-01800-w","DOIUrl":"10.1038/s41440-024-01800-w","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626611","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":"Differences in the effectiveness and safety of different renal denervation devices.","authors":"Yukako Ogoyama, Kazuomi Kario","doi":"10.1038/s41440-024-01801-9","DOIUrl":"https://doi.org/10.1038/s41440-024-01801-9","url":null,"abstract":"<p><p>Renal denervation (RDN) is a minimally invasive, endovascular catheter-based procedure using radiofrequency, ultrasound, or alcohol-mediated ablation to treat resistant hypertension. RDN gained popularity in 2009 when it was shown to have an antihypertensive effect. However, concerns about the efficacy of RDN were raised in the HTN-3 trial published in 2014, and the development of several RDN devices was then discontinued. In the process, new randomized controlled trials were conducted after the development of some of the RDN devices, the quality assurance of the procedure, changes in ablation points, and improvements in study design. In November 2023, the U.S. Food and Drug Administration approved a radiofrequency RDN device and an ultrasound RDN device. The results of a randomized controlled trial of an alcohol-mediated RDN device have been published, and future trends are being watched closely. In this mini-review, we summarize the differences in the antihypertensive effect and safety of the different RDN devices and the endpoints of the procedure in order to contribute to the further development of RDN devices Currently available renal denervation device. A multielectrode radiofrequency ablation (Spyral), (B) ultrasound denervation (Paraise), and (C) alcohol-mediated perivascular denervation (Peregrine). ASBP ambulatory systolic blood pressure, ADBP ambulatory diastolic blood pressure, OSBP office systolic blood pressure, ODBP office diastolic blood pressure. Analysis according to types of renal denervation device (radiofrequency, ultrasound, or alcohol-mediated device). P values for interaction were 0.578 (ambulatory SBP), 0.499 (ambulatory diastolic BP), 0.853 (office SBP), and 0.870 (office diastolic BP).</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626557","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":"Resistant hypertension: diagnosis, evaluation, and treatment a clinical consensus statement from the Thai hypertension society","authors":"Pairoj Chattranukulchai,&nbsp;Weranuj Roubsanthisuk,&nbsp;Sirisawat Kunanon,&nbsp;Praew Kotruchin,&nbsp;Bancha Satirapoj,&nbsp;Nattawut Wongpraparut,&nbsp;Sarat Sunthornyothin,&nbsp;Apichard Sukonthasarn","doi":"10.1038/s41440-024-01785-6","DOIUrl":"10.1038/s41440-024-01785-6","url":null,"abstract":"Resistant hypertension (RH) includes hypertensive patients with uncontrolled blood pressure (BP) while receiving ≥3 BP-lowering medications or with controlled BP while receiving ≥4 BP-lowering medications. The exact prevalence of RH is challenging to quantify. However, a reasonable estimate of true RH is around 5% of the hypertensive population. Patients with RH have higher cardiovascular risk as compared with hypertensive patients in general. Standardized office BP measurement, confirmation of medical adherence, search for drug- or substance-induced BP elevation, and ambulatory or home BP monitoring are mandatory to exclude pseudoresistance. Appropriate further investigations, guided by clinical data, should be pursued to exclude possible secondary causes of hypertension. The management of RH includes the intensification of lifestyle interventions and the modification of antihypertensive drug regimens. The essential aspects of lifestyle modification include sodium restriction, body weight control, regular exercise, and healthy sleep. Step-by-step adjustment of the BP-lowering drugs based on the available evidence is proposed. The suitable choice of diuretics according to patients’ renal function is presented. Sacubitril/valsartan can be carefully substituted for the prior renin-angiotensin system blockers, especially in those with heart failure with preserved ejection fraction. If BP remains uncontrolled, device therapy such as renal nerve denervation should be considered. Since device-based treatment is an invasive and costly procedure, it should be used only after careful and appropriate case selection. In real-world practice, the management of RH should be individualized depending on each patient’s characteristics.","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41440-024-01785-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive blood pressure management in patients using multiple classes of antihypertensive drugs or with resistant hypertension","authors":"Keisuke Narita,&nbsp;Kazuomi Kario","doi":"10.1038/s41440-024-01803-7","DOIUrl":"10.1038/s41440-024-01803-7","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41440-024-01803-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}