Hypertension Research最新文献

{"title":"Small vessel disease increases risk of poor outcome through stroke and dementia.","authors":"Kazuo Kitagawa, Sono Toi, Hiroshi Yoshizawa, Kenichi Todo","doi":"10.1038/s41440-025-02242-8","DOIUrl":"https://doi.org/10.1038/s41440-025-02242-8","url":null,"abstract":"<p><p>Hypertension is the most significant risk factor of cerebral small vessel disease (SVD). SVD raises the likelihood of poor functional outcomes in independent older adults, though the underlying causes remains uncertain. This study aimed to investigate the link between incident events and poor functional outcomes in individuals with SVD. In this post hoc analysis, data were sourced from a Japanese observational registry, including 1011 patients with cerebral vessel disease evident on magnetic resonance imaging and vascular risk factors. Follow-up continued until March 2023. After excluding participants with suspected dementia, Modified Rankin Scale (mRS) scores of 2 or more, or missing Mini-Mental State Examination results, 859 patients were analyzed. SVD was defined as moderate to severe white matter hyperintensity (WMH) and/or the presence of lacune. The study's outcome was a poor functional status defined as a mRS score ≥3 at the last visit. Over a median follow-up of 4.6 years, 50 patients died, and 85 experienced poor functional outcomes. WMH or lacune were associated with an increased risk of all-cause mortality and poor functional outcomes. Key causes of death included cancer, heart disease, pneumonia and senility, while stroke, dementia and fall-related injuries also elevated the risk of poor functional outcomes. WMH or lacune specifically heightened the risk of stroke and dementia. In conclusion, SVD elevates the risk of poor functional outcomes primarily via incident stroke and dementia. To maintain independence in daily activities among elderly individuals, targeted prevention of stroke and dementia is crucial in patients with SVD. Proposed mechanism linking small vessel disease, typically white matter hyperintensity/lacune, with poor functional outcome. Seven incident events, neoplasm, heart disease, stroke, dementia, falls, pneumonia, and motor function impairment, potentially related to poor functional outcomes. In elderly patients, SVD significantly increases the risk of stroke, and moderately raises the risk of dementia, pneumonia, and motor impairment which may be related to senility. This relationship helps explain why patients with SVD are more likely to experience poor functional outcomes compared to those without SVD.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225330","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":"Mild autonomous cortisol secretion in primary aldosteronism: the origin of cortisol.","authors":"Hironobu Umakoshi","doi":"10.1038/s41440-025-02245-5","DOIUrl":"https://doi.org/10.1038/s41440-025-02245-5","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215698","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 impact of blood pressure and its variability on suicide mortality: a nationwide population-based study.","authors":"Jeongmin Lee, Jeongeun Kwak, Jin-Hyung Jung, Dong Woo Kang, Mee Kyoung Kim, Dong-Jun Lim, Hyuk-Sang Kwon, Jung Min Lee, Sang-Ah Chang, Kyungdo Han, Seung-Hwan Lee","doi":"10.1038/s41440-025-02244-6","DOIUrl":"https://doi.org/10.1038/s41440-025-02244-6","url":null,"abstract":"<p><p>The association between blood pressure (BP) and its variability (BPV) with psychological disorders has been established. We aimed to investigate whether this relationship extends to the risk of suicide in a large, nationally representative cohort. This retrospective cohort study included 1,983,107 participants from the Korean National Health Insurance Service database, collected between 2005 and 2009, with 11.1 years of follow-up. BPV was assessed using at least three health examination datasets and validated variability indices (variability independent of the mean [VIM], average successive variability, and coefficient of variation). The primary endpoint was suicide-related death. Cox proportional hazards models were used to estimate hazard ratios (HRs) for suicide across BPV quartiles. Higher BP and BPV were significantly associated with an increased risk of suicide. Participants in the highest quartile (Q4) of systolic BPV (VIM) had an adjusted HR of 1.13 (95% CI: 1.05-1.22) for suicide. Similarly, those in Q4 of diastolic BPV (VIM) had an HR of 1.16 (95% CI: 1.08-1.24). This association was particularly pronounced in older adults (≥65 years), with an HR of 1.18 (95% CI: 1.03-1.36) for systolic BPV and 1.21 (95% CI: 1.05-1.39) for diastolic BPV in Q4. Consistent findings were observed when using different variability indices. Subgroup analyses according to sex, diabetes, depression, hypertension, and use of antihypertensive medications also supported these findings. These findings suggest that both BP and BPV are novel risk factors for suicide mortality. Considering BP and BPV together may enhance the identification of individuals at higher risk of suicide.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215699","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":"Makurazaki: a city of zero-hypertension.","authors":"Mitsuru Ohishi, Yuichi Akasaki","doi":"10.1038/s41440-025-02232-w","DOIUrl":"https://doi.org/10.1038/s41440-025-02232-w","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215697","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":"Effectiveness of self-monitoring devices measuring the urinary sodium-to-potassium ratio, urinary salt (sodium) excretion, or salt concentration in foods for blood pressure management: a systematic review and meta-analysis.","authors":"Takashi Hisamatsu, Kohei Ueda, Kimika Arakawa, Shintaro Minegishi, Yukiko Okami, Minako Kinuta, Keiko Kondo, Hiroshige Jinnouchi, Maho Ishihara, Makiko Abe, Atsushi Sakima, Katsuyuki Miura, Hisatomi Arima","doi":"10.1038/s41440-025-02124-z","DOIUrl":"10.1038/s41440-025-02124-z","url":null,"abstract":"<p><p>Self-monitoring devices that measure the urinary sodium-to-potassium (Na/K) ratio, urinary salt or sodium excretion, or salt concentration in foods have emerged as tools that can guide dietary adjustments for blood pressure (BP) control. This systematic review and meta-analysis investigated whether these self-monitoring devices can help to control BP in adults. The PubMed, Cochrane Library, and Ichushi-Web databases were searched to identify randomized controlled trials that compared the effect of these devices (with or without additional dietary education) plus usual care on BP with that of usual care alone. The pooled effect of weighted mean difference between the intervention and control groups at the end of follow-up was estimated by random-effects meta-analysis. The primary outcome was the change in BP. Secondary outcomes included changes in the urinary Na/K ratio, and sodium and potassium excretions. Of 1525 studies screened, eight (with 1442 participants) were eligible for inclusion. Meta-analysis showed greater reductions in systolic BP by 2.45 (95% confidence interval, 0.04, 4.86) mmHg and diastolic BP by 1.38 (-0.15, 2.90) mmHg in the intervention vs. control groups. However, heterogeneity was high (I² = 69.4% for systolic BP and 65.1% for diastolic BP). The BP-lowering effect was not statistically different across different follow-up durations (4 weeks or 2-6 months) and intervention approaches (self-monitoring alone or combined with dietary education) (all p values for heterogeneity >0.1). Reductions in the urinary Na/K ratio and sodium excretion were greater in the intervention group. Self-monitoring devices may assist with BP reduction by promoting decreased sodium intake and increased potassium intake.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":"1891-1898"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407325","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-based telemonitoring care and executive function in patients with heart failure.","authors":"Tetsuya Kaneko, Atsushi Tanaka, Ayako Takamori, Hiroshi Hongo, Yoshiko Sakamoto, Ayumu Yajima, Machiko Asaka, Tsuneki Ajimi, Kohei Kamishita, Yohei Inoue, Daisuke Nagatomo, Daisuke Fujimatsu, Norihiko Kotooka, Koichi Node","doi":"10.1038/s41440-025-02199-8","DOIUrl":"10.1038/s41440-025-02199-8","url":null,"abstract":"<p><p>Enhancement of self-care ability is essential for patients with heart failure (HF), and executive function plays a critical role. We investigated the clinical influence of a home-based remote care program using telemonitoring and telecoaching on executive function in patients with HF and assessed the relationship between executive functional status and clinical outcomes. This prospective study enrolled outpatients with HF, and they received home-based remote care program with telemonitoring and telecoaching using self-measured physical data. Executive function was assessed using the Trail Making Test Part B (TMT-B). The incidences of HF hospitalization and all-cause death were also compared according to baseline executive function status based on TMT-B test performance. Forty-one participants were enrolled in this study (mean age: 64.8 ± 13.8 years; male 68.3%; New York Heart Association [NYHA] class II/III: 78.0/22.0%). Twelve months after the initiation of the program, TMT-B significantly improved (p = 0.039), accompanied by an obvious amelioration of HF symptoms as assessed by the NYHA class (p = 0.027). During a median follow-up of 20.5 months, the incidence of HF hospitalization was significantly higher in patients with executive dysfunction than in those without (hazard ratio: 4.97, 95% confidence interval: 1.15-21.4, p = 0.031). This was unchanged even in a subcohort without cognitive dysfunction, as assessed using the Mini-Mental State Examination. Telemonitoring and telecoaching at home may be effective in improving executive function in patients with HF. Further studies are needed to assess whether supportive care assisting executive functioning improves clinical outcomes in patients with HF.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":"1919-1928"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002125","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":"1899-1910"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","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":"Long-term microvascular and blood pressure dysregulation after Preeclampsia.","authors":"Maya Jälmby, Camilla Edvinsson, Despoina Lykou, Grigorios Karampas, Lena Erlandsson, Stefan R Hansson, Federica Piani","doi":"10.1038/s41440-025-02176-1","DOIUrl":"10.1038/s41440-025-02176-1","url":null,"abstract":"<p><p>Preeclampsia (PE) is a pregnancy disorder characterized by systemic endothelial damage that leads to long-term cardiovascular complications. The endothelial glycocalyx (EG) covers the luminal surface of endothelium playing a critical role in vascular homeostasis. In this study we aimed to evaluate EG thickness and blood pressure (BP) trends in women with a history of PE vs. normotensive pregnancy. Fifty-five women participated in the study (18 controls, 34 with PE, and 3 with gestational hypertension). Six years postpartum, we evaluated the sublingual microcirculation by sidestream dark-field microscopy, and assessed BP in the sitting and orthostatic position. At follow-up, women with PE had reduced EG thickness in vessels ≥ 8 µm, expressed by an increased perfused boundary region (PBR), compared to healthy controls (median 3.14 vs. 2.88 µm, p = 0.002). A trend towards increased red blood cell velocity in vessels ≥ 10 µm was also observed in PE vs. controls. The systolic and diastolic BP, as well as within-visit BP variability, were significantly higher in PE vs. controls. Adverse neonatal outcomes, umbilical artery Doppler and BP during both the pregnancy and the follow-up visit, were associated with maternal PBR value in vessels ≥ 8 µm. This study contributes to the existing literature on PE and the increased risk of future cardiovascular disease, highlighting the critical role of EG and BP regulatory mechanisms. Our results showed that the severity of hemodynamic and neonatal impairments during pregnancy may irreversibly affect the EG and thereby be associated with long-term maternal vascular dysfunction.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":"1972-1982"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772005","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":"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":"1859-1869"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","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":"Correction: Personalised hypertension management with accurate blood pressure measurement: much achieved, much more to do.","authors":"James E Sharman","doi":"10.1038/s41440-025-02198-9","DOIUrl":"10.1038/s41440-025-02198-9","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":"2017"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709761","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}