Hypertension最新文献

{"title":"East and South Asian-Specific Blood Pressure Trajectories and Cardiovascular Disease.","authors":"So Mi J Cho, Sarah Urbut, Yunfeng Ruan, Aarushi Bhatnagar, Shriienidhie Ganesh, Whitney E Hornsby, Romit Bhattacharya, Michael C Honigberg, Stephen P Juraschek, Eugene Yang, Daichi Shimbo, Pradeep Natarajan","doi":"10.1161/HYPERTENSIONAHA.124.23985","DOIUrl":"10.1161/HYPERTENSIONAHA.124.23985","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) risk differs across Asian subgroups, possibly due to differences in hypertension burden. We characterized lifetime blood pressure (BP) trajectories for East and South Asian individuals and compared their associations with CVD risk.</p><p><strong>Methods: </strong>Among 148 872 UK Biobank participants with primary care utilization data, life course BP trajectories were fitted as a function of age by sex according to self-identified ethnicity. We determined associations of time-averaged young adulthood (18-39 years), middle age (40-64 years), and later life (≥65 years) systolic BP (SBP) and diastolic BP with incident atherosclerotic CVD risk.</p><p><strong>Results: </strong>The predicted SBP/diastolic BP (95% CI) at age 30 years was 108 (103-114)/68 (65-71) mm Hg for East Asian and 114 (110-118)/72 (71-73) mm Hg for South Asian individuals. By age 40, South Asian individuals were projected to reach an SBP of 130.0 mm Hg, whereas East Asian individuals reached the equivalent SBP by age 49 years. Among South Asian individuals, each SD increase in young adulthood SBP was associated with a higher atherosclerotic CVD risk with an odds ratio (95% CI) of 1.41 (1.12-1.75), but not among East Asians (<i>P</i>_interaction=0.01). Midlife SBP was associated with peripheral artery disease among South Asian individuals (odds ratio, 2.08 [95% CI, 1.51-2.88]) and with ischemic stroke among East Asian individuals (odds ratio, 3.84 [95% CI, 1.08-5.07]). Later-life SBP was associated with myocardial infarction risk by 1.52 (1.15-1.92)-fold among South Asians and ischemic stroke by 2.50 (1.06-3.80)-fold among East Asian individuals.</p><p><strong>Conclusions: </strong>East and South Asian individuals exhibit distinct BP trajectories that age-differentially associate with incident CVD. Disaggregating Asian subgroups may inform tailored hypertension screening and management.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"520-531"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macrophages Regulate Inflammatory Vascular Remodeling in Pulmonary Hypertension.","authors":"Fahimeh Varzideh, Imma Forzano, Emanuele Farroni, Pasquale Mone, Urna Kansakar, Gaetano Santulli","doi":"10.1161/HYPERTENSIONAHA.124.24309","DOIUrl":"10.1161/HYPERTENSIONAHA.124.24309","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"82 3","pages":"460-462"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Trials in Hypertension: A Mathematical Endorsement for Diagnosis and Treatment.","authors":"Flavio D Fuchs, Sandra C Fuchs, Otavio Berwanger, Paul K Whelton","doi":"10.1161/HYPERTENSIONAHA.124.21361","DOIUrl":"10.1161/HYPERTENSIONAHA.124.21361","url":null,"abstract":"<p><p>Elevated blood pressure (BP) remains the leading cause of mortality globally, and efforts to control it have been disappointing. Meta-analyses of antihypertensive randomized controlled trials reveal a near-exact reversal of the BP-related risks identified in cohort studies. For an observed increase in cardiovascular disease risk of 12.5%, 25%, 50%, and 75% with a 5, 10, 20, or 40 mm Hg higher level of BP, respectively, the corresponding BP reductions in antihypertensive randomized controlled trial meta-analyses document a reversal of risks by 7%, 17% of 22%, 54%, and 64%, respectively, providing almost perfect mathematical concordance between the observed and expected benefit of antihypertensive treatment. Treatment benefits have been demonstrated across a wide range of baseline BPs and in individuals with and without prior established cardiovascular disease. Meta-analyses of antihypertensive treatment randomized controlled trials also indicate that the treatment benefits far outweigh any potential risks for adverse effects. The mathematical evidence of the effectiveness of BP-lowering in reducing the incidence of BP-related cardiovascular disease without imposing relevant adverse effects should be considered by clinicians and guideline committees in defining the diagnosis of hypertension and establishing antihypertensive treatment goals. Setting lower BP values for the diagnosis and treatment of hypertension could yield a substantial reduction in the global burden of disease due to high BP.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"82 3","pages":"411-418"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic Aging: A Mechanism by Which Social Determinants Increase the Risk of Hypertension?","authors":"Alexander Chaitoff, Daichi Shimbo, Adam P Bress","doi":"10.1161/HYPERTENSIONAHA.124.24434","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.24434","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"82 3","pages":"e25-e27"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Frailty on Antihypertensive Treatment in Older Adults.","authors":"Linan Chen, Shoujiang You, Nicole Ee, Kenneth Rockwood, David D Ward, Mark Woodward, Tao Liu, Yijie Gao, Jeff D Williamson, Craig S Anderson, Katie Harris, Xiaoying Chen, Ruth Peters","doi":"10.1161/HYPERTENSIONAHA.124.24214","DOIUrl":"10.1161/HYPERTENSIONAHA.124.24214","url":null,"abstract":"<p><strong>Background: </strong>The association between systolic blood pressure and all-cause mortality differs between frail and nonfrail individuals, highlighting uncertainties about the effectiveness of antihypertensive treatments in frail populations.</p><p><strong>Methods: </strong>Using data from the SHEP trial (Systolic Hypertension in the Elderly Program), a baseline frailty index (FI), including 55 variables, was constructed. Fine-Gray subdistribution hazard models and Cox proportional hazards regression models were used to explore the association between baseline FI and the risks of stroke, cardiovascular disease, and all-cause death, as well as to examine whether the impact of antihypertensive treatment on these outcomes was modified by baseline FI.</p><p><strong>Results: </strong>A total of 4692 participants (mean age, 72.1 years; 56.7% women) were included, with a mean (SD) FI of 0.134 (0.061). During a median follow-up period of 4.4 years, FI was associated with a higher risk of stroke (subdistribution hazard ratio, 1.24 [95% CI, 1.10-1.39]; per SD higher FI), cardiovascular disease (subdistribution hazard ratio, 1.18 [95% CI, 1.09-1.26]), and all-cause death (hazard ratio, 1.37 [95% CI, 1.26-1.50]), after adjustment for age, sex, race, education and treatment group. Although those with higher levels of frailty were at higher risk for all outcomes, there was no evidence of an interaction between baseline FI and antihypertensive treatment (<i>P</i> for interaction >0.05 for all outcomes).</p><p><strong>Conclusions: </strong>In individuals with isolated systolic hypertension, antihypertensive treatment improved associated outcomes even among those with a higher degree of frailty. These findings from the SHEP trial reinforce evidence from other seminal antihypertensive trials, which collectively inform the appropriate treatment of frail individuals with hypertension.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT00000514.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"509-519"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation Status of Electronic Sphygmomanometers in China: A National Survey.","authors":"Xianghui Zhang, Zhimin Xu, Yingchun Yao, Huilei Zheng, Jian Wu, Jingwen Hu, Shenggen Wu, Quanjun Lyu, Yong Liu, Min Wu, Liangxia Chen, Lina Xu, Haiyan Zhou, Peifen Duan, Jianghong Dai, Hong Ding, Shuang Wang, Yi Zhao, Jihong Hu, Liyue Zhu, Rong Hai, Baoliang Zhong, Huilian Zhu, Kui Li, Yao Lu, Shaowen Tang, Xingming Li, Yan Zhang, Zongtao Chen, Tongyu Wang, Mei Li, Fuxu Liu, Chengluan Liu, Xiaoling Yang, Lihua Dong, Jixiang Ma, Pei Gao, Wuxiang Xie, Yangfeng Wu","doi":"10.1161/HYPERTENSIONAHA.124.24203","DOIUrl":"10.1161/HYPERTENSIONAHA.124.24203","url":null,"abstract":"<p><strong>Background: </strong>Although the information on the validation status of electronic sphygmomanometer (ES) devices in use in health care institutions and households is much more clinically relevant than that of ES models available on the market, it remains insufficient.</p><p><strong>Methods: </strong>A national survey was conducted across all administrative regions of mainland China to assess the validation status of ESs. Fifty-eight cities were selected with stratification by municipality, provincial capital, and other cities, and health care institutions and households in each city were chosen by convenience to identify ES devices in use according to the study protocol. Information on devices' model, type, was collected. The validation status of each device was ascertained through searching international online registries of its models.</p><p><strong>Results: </strong>A total of 3230 ES devices (1924 from health care institutions and 1306 from households), encompassing 498 ES models, were actually selected. The weighted proportion of accuracy-validated devices was significantly higher in health care institutions (33.9% [95% CI, 31.8-36.0%]) compared with households (23.0% [95% CI, 20.8-25.4%]; <i>P</i><0.001), and both exceeded the proportions for models (17.7% [95% CI, 13.7-22.6%] and 12.5% [95% CI, 9.5-16.3%], respectively). Regional economic development, device type, and years in use were associated with the proportion of accuracy-validated devices. Notably, 8.8% of devices used in secondary hospitals were wrist type.</p><p><strong>Conclusions: </strong>The accuracy validation status of ESs in China in the number of devices in use shows a more favorable situation than that in the number of models but remains low and concerning. Policies are urgently needed to promote the widespread adoption of accuracy-validated models among all users.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"532-541"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Obesity Prevalence Among Adults With Hypertension in the United States, 2001 to 2023.","authors":"Jiabin Tu, Hongkui Chen, Qingfeng Zeng, Liling Chen, Yansong Guo, Kaihong Chen","doi":"10.1161/HYPERTENSIONAHA.124.24123","DOIUrl":"10.1161/HYPERTENSIONAHA.124.24123","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a factor contributing to the occurrence of hypertension and a risk factor for adverse outcomes in populations with hypertension. The changes in the prevalence of obesity in populations with hypertension remain unclear. Investigating the changes in the prevalence of obesity in populations with hypertension can provide information for the treatment and management of hypertension.</p><p><strong>Methods: </strong>The clinical data from adults aged ≥20 years with hypertension were extracted from the National Health and Nutrition Examination Survey 2001 to 2023. The primary outcome was the prevalence of obesity (body mass index≥30 kg/m²). The trend in the prevalence of obesity among American adults with hypertension was evaluated via a trend test.</p><p><strong>Results: </strong>The age-standardized prevalence of obesity among populations with hypertension in America increased from 39.6% in 2001 to 55.4% in 2023 (<i>P</i> for trend<0.001). This trend was observed in men (35.4%-53.6%; <i>P</i> for trend<0.001) and women (45.6%-57.7%; <i>P</i> for trend<0.001) populations with hypertension. While the prevalence of grade II (35 kg/m²≤body mass index<40 kg/m²) and grade III obesity (body mass index≥40 kg/m²) increased significantly in both sexes, the prevalence of grade I obesity (30 kg/m²≤body mass index<35 kg/m²) increased significantly only in men (23.2%-30.0%; <i>P</i> for trend=0.003) and did not significantly change in women (22.2%-21.7%; <i>P</i> for trend=0.135).</p><p><strong>Conclusions: </strong>The prevalence of obesity among American adults with hypertension increased from 2001 to 2023. In men, the prevalence of grades I, II, and III obesity increased. Among women, the prevalence of only grades II and III obesity increased.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"498-508"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time in Target Range for Blood Pressure and Adverse Health Outcomes: A Systematic Review.","authors":"Huairong Wang, Jialu Song, Zhike Liu, Huan Yu, Kun Wang, Xueying Qin, Yiqun Wu","doi":"10.1161/HYPERTENSIONAHA.124.24013","DOIUrl":"10.1161/HYPERTENSIONAHA.124.24013","url":null,"abstract":"<p><strong>Background: </strong>Blood pressure (BP) time in target range (TTR) reflects the proportion of time that BP measurement is within a specified target range. We aim to summarize the evidence for relationships between TTR and adverse health outcomes.</p><p><strong>Methods: </strong>Seven databases were searched. After quality assessment and data extraction, meta-analyses were performed to generate pooled estimates of the association (hazard ratios) between TTR and health outcomes. Primary outcomes were all-cause mortality and cardiovascular death. Secondary outcomes included major adverse cardiovascular events, myocardial infarction, stroke, heart failure, atrial fibrillation, and adverse kidney events.</p><p><strong>Results: </strong>In all, 21 studies were included, mostly rated at low risk of bias. TTR was defined by systolic BP (SBP) in 15 studies and by both SBP and diastolic BP in 6 studies. Per SD increase of TTR was associated with significantly decreased risks of all-cause mortality (110-130 mm Hg SBP TTR: hazard ratios, 0.85 [95% CI, 0.82-0.89]; 120-140 mm Hg SBP TTR: 0.81 [95% CI, 0.70-0.94]; and 70-80 mm Hg diastolic BP TTR: 0.88 [95% CI, 0.83-0.93]), cardiovascular death (110-130 mm Hg SBP TTR: 0.83 [95% CI, 0.78-0.87]; 120-140 mm Hg SBP TTR: 0.76 [95% CI, 0.65-0.89]; and 70-80 mm Hg diastolic BP TTR: 0.85 [95% CI, 0.80-0.90]), major adverse cardiovascular events (120-140 mm Hg SBP TTR: 0.76 [95% CI, 0.70-0.83]), and heart failure (110-130 mm Hg SBP TTR: 0.84 [95% CI, 0.76-0.93] and 120-140 mm Hg SBP TTR: 0.78 [95% CI, 0.68-0.89]). However, there was not sufficient support for the association of TTR with myocardial infarction, stroke, atrial fibrillation, or adverse kidney events.</p><p><strong>Conclusions: </strong>Higher TTR was associated with reduced risks of all-cause mortality, cardiovascular death, major adverse cardiovascular events, and heart failure, highlighting the importance of sustained BP control in clinical practice.</p><p><strong>Registration: </strong>URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42023486437.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"419-431"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular Smooth Muscle Cell TG2 Promotes DOCA/Salt-Induced Arterial Stiffness and Hypertension.","authors":"Annayya R Aroor, Huma Naz, Jack Hulse, Taylor J Kelty, Neekun Sharma, Guanghong Jia, Adam Whaley-Connell, R Scott Rector, Camila Manrique-Acevedo, Guido Lastra","doi":"10.1161/HYPERTENSIONAHA.124.23518","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.23518","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"82 3","pages":"e31-e33"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the Gap in Global Disparities in Hypertension Control.","authors":"Shiva Raj Mishra, Gautam Satheesh, Vishnu Khanal, Tu N Nguyen, Dean Picone, Niamh Chapman, Richard I Lindley","doi":"10.1161/HYPERTENSIONAHA.124.24137","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.24137","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"82 3","pages":"407-410"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}