HypertensionPub Date : 2024-12-01Epub Date: 2024-09-30DOI: 10.1161/HYPERTENSIONAHA.124.21727
Tomoyuki Tobushi, John S Floras
{"title":"Awakening to the Pertinence of Sleep for Hypertension.","authors":"Tomoyuki Tobushi, John S Floras","doi":"10.1161/HYPERTENSIONAHA.124.21727","DOIUrl":"10.1161/HYPERTENSIONAHA.124.21727","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"2407-2409"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345733","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}
HypertensionPub Date : 2024-12-01Epub Date: 2024-11-11DOI: 10.1161/HYPERTENSIONAHA.124.23670
Madeleine Johansson, Marcus Ståhlberg, Fabrizio Ricci, Christian Lewinter, Viktor Hamrefors, Peter M Nilsson, Richard Sutton, Artur Fedorowski
{"title":"Blood Pressure Regulation in Post-COVID POTS: Beyond Sinus Tachycardia.","authors":"Madeleine Johansson, Marcus Ståhlberg, Fabrizio Ricci, Christian Lewinter, Viktor Hamrefors, Peter M Nilsson, Richard Sutton, Artur Fedorowski","doi":"10.1161/HYPERTENSIONAHA.124.23670","DOIUrl":"10.1161/HYPERTENSIONAHA.124.23670","url":null,"abstract":"<p><strong>Background: </strong>Postural orthostatic tachycardia syndrome (POTS) is a frequently diagnosed cardiovascular disorder after COVID-19 infection. POTS is characterized by the presence of excessive sinus tachycardia on standing without a fall in blood pressure (BP). We investigated the BP profile using 24-hour ambulatory BP monitoring in patients with new-onset POTS after COVID-19 compared with prepandemic population-based controls.</p><p><strong>Methods: </strong>We performed a case-control study in 100 patients (mean age, 40.0±12.9 years; 85% women) with verified post-COVID-19 new-onset POTS diagnosed by a positive head-up tilt testing versus 100 controls from a population-based cohort with a negative active standing test, no history of syncope, POTS, or endocrine disease (mean age, 42.3±14.0 years; 78% women). Twenty-four-hour BP profile was assessed for circadian BP variation including hypotensive systolic BP (SBP) episodes (<80, <90, and <100 mm Hg).</p><p><strong>Results: </strong>Patients with post-COVID-19 POTS had significantly higher nighttime SBP, but not daytime SBP, and more daytime SBP hypotensive episodes compared with controls. Nondipping (34% versus 19%; <i>P</i><0.001) and reverse dipping patterns (9% versus 0%; <i>P</i><0.001) were more frequent in post-COVID-19 POTS. In the logistic regression, patients with post-COVID-19 POTS had significantly higher mean 24-hour SBP (odds ratio, 1.08 [95% CI, 1.04-1.11]; <i>P</i><0.001) and nighttime SBP (odds ratio, 1.07 [95% CI, 1.04-1.10]; <i>P</i><0.001), independent of age and sex.</p><p><strong>Conclusions: </strong>Patients with post-COVID-19 POTS demonstrate higher mean 24-hour and nighttime SBP and show disruptions of circadian BP rhythm regulation compared with population-based controls, as well as more daytime hypotensive episodes. Future studies are needed to test whether patients with post-COVID-19 POTS may benefit from tailored BP therapy.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"2540-2548"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619255","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}
HypertensionPub Date : 2024-11-21DOI: 10.1161/HYPERTENSIONAHA.124.23188
Jacquie R Baker, Paul A Beach, Shaun I Ranada, Aishani Patel, Jennifer Gewandter, Can Ozan Tan, Roy Freeman, Satish R Raj
{"title":"Cerebral Blood Flow Dynamics in Neurogenic Orthostatic Hypotension: A Systematic Review and Meta-Analysis.","authors":"Jacquie R Baker, Paul A Beach, Shaun I Ranada, Aishani Patel, Jennifer Gewandter, Can Ozan Tan, Roy Freeman, Satish R Raj","doi":"10.1161/HYPERTENSIONAHA.124.23188","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.23188","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic orthostatic hypotension (nOH) causes pathological falls in standing blood pressure that may or may not be symptomatic. nOH also raises the risk of poor neurological outcomes irrespective of symptom presence, possibly reflecting subclinical cerebral hypoperfusion. Dynamic changes in cerebral blood flow velocity (CBFv) help infer how blood pressure fluctuations influence CBFv and cerebral autoregulation. Whether CBFv is impacted in nOH relative to related conditions without nOH and healthy controls (HC) remains unresolved. Whether nOH symptoms reflect greater CBFv falls is also unclear. This review aimed to compare CBFv between nOH and HC, nOH and disease-matched controls (eg, Parkinson disease±nOH), and between symptomatic and asymptomatic nOH.</p><p><strong>Methods: </strong>Embase and MEDLINE were searched up to April 2024. Means, SDs, and sample sizes for supine and upright CBFv were extracted to generate standardized effect sizes (Hedge g). Random-effects modeling compared postintervention between-group effect sizes.</p><p><strong>Results: </strong>Seventeen studies were included for review. Thirteen studies were suitable for meta-analysis comparing nOH to HC, 2 comparing disease-matched controls to nOH and to HC, and 3 for symptomatic comparisons. Compared with HC, nOH had larger drops in CBFv (Hedge g, -0.64 [95% CI, -0.85 to -0.44]; <i>P</i><0.001). CBFv falls between nOH and disease-matched controls were similar (<i>P</i>=0.17). Symptomatic nOH had larger CBFv drops (Hedge g, 0.84 [95% CI, 0.212-1.461]; <i>P</i>=0.009) than asymptomatic nOH.</p><p><strong>Conclusions: </strong>nOH causes significant orthostatic reductions in CBFv compared with HC, and symptomatic patients experience greater falls in CBFv than asymptomatic patients. Recognizing the clinical implications of CBFv in nOH is crucial for mitigating adverse outcomes.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681734","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}
HypertensionPub Date : 2024-11-21DOI: 10.1161/HYPERTENSIONAHA.124.23393
Christian Delles, Roland E Schmieder, Rónán Daly, Dennis Kannenkeril, Agnes Bosch, Lucas Lauder, Michael Kunz, Michael Böhm, Graham Hamilton, Raphael S Schmieder, Axel Schmid, Pawel Herzyk, Felix Mahfoud
{"title":"Response of Blood Pressure to Renal Denervation Is Not Associated With Genetic Variants.","authors":"Christian Delles, Roland E Schmieder, Rónán Daly, Dennis Kannenkeril, Agnes Bosch, Lucas Lauder, Michael Kunz, Michael Böhm, Graham Hamilton, Raphael S Schmieder, Axel Schmid, Pawel Herzyk, Felix Mahfoud","doi":"10.1161/HYPERTENSIONAHA.124.23393","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.23393","url":null,"abstract":"<p><strong>Background: </strong>Renal denervation lowers blood pressure (BP) in patients with uncontrolled hypertension. We conducted an unbiased genomic screen to identify genetic variants that may associate with BP response to renal denervation (RDN).</p><p><strong>Methods: </strong>Patients (n=268) with uncontrolled resistant hypertension (baseline BP, 166±21/90±15 mm Hg) who underwent endovascular RDN using the Symplicity catheter (Medtronic, Inc, Santa Rosa, CA) were included. Reduction in 24-hour ambulatory systolic BP was assessed at 6 months and divided into 2 groups: above and below the median response of 6.0 mm Hg, taking preintervention 24-hour ambulatory BP and regression to the mean into account. Whole exome sequencing assessing 249 669 variants, was conducted using Illumina NovaSeq technology read on a NovaSeq S4 Flow Cell device.</p><p><strong>Results: </strong>We did not identify individual gene variants associated with BP response following RDN. These findings were confirmed after adjustment for sex and in a sensitivity analysis looking at tertiles of BP response. We also explored specific variants in <i>AGT</i>, <i>ADD1</i>, ADRB1, <i>ADRB2</i>, and <i>SCNN1A</i> that have been proposed as potential candidate genes for response and found no association (all <i>P</i>>0.13). Gene ontology analysis of variants across the 2 responder groups highlighted differences in biologic processes such as cell adhesion and molecular function such as protein tyrosine kinase activity.</p><p><strong>Conclusions: </strong>The response to RDN, in terms of 24-hour BP reduction, was not associated with the genetic profile of patients with resistant hypertension. These data do not support the use of a genetic score to identify potential responders to RDN.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681735","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}
HypertensionPub Date : 2024-11-14DOI: 10.1161/HYPERTENSIONAHA.124.23549
Giuseppe Mancia, Rita Facchetti, Fosca Quarti-Trevano, Guido Grassi
{"title":"Reproducibility and Treatment Effect on Office and Ambulatory Pressure Relation.","authors":"Giuseppe Mancia, Rita Facchetti, Fosca Quarti-Trevano, Guido Grassi","doi":"10.1161/HYPERTENSIONAHA.124.23549","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.23549","url":null,"abstract":"<p><strong>Background: </strong>In the absence of outcome-based ambulatory blood pressure (BP) data hypertension guidelines provide 24-hour mean BP values corresponding to trial-validated office BP values. Data are shown for untreated and treated patients together, but whether corresponding ambulatory values are similar in untreated and treated hypertensives and reproducible at yearly measurements during treatment is undefined.</p><p><strong>Methods: </strong>In 2397 patients of the ELSA (European Lacidipine Study on Atherosclerosis) and PHYLLIS (Plaque Hypertension Lipid-Lowering Italian Study) trials, we calculated the office and 24-hour BP relationship according to the linear regression model, with office systolic BP as the independent variable, at baseline and yearly during a 3-year treatment. Twenty-four hour BP values corresponding to clinically important office BP values (hypertension grades and treatment thresholds and targets) were calculated and compared with those provided by guidelines.</p><p><strong>Results: </strong>Office/24-hour systolic BP or diastolic BP always exhibited a significant linear relationship, with, however, limited Pearson correlation coefficients (never >0.44).The slopes of the relationship were superimposable between different years of treatment but always significantly less steep than the slope seen in untreated individuals. Compared with the guideline-provided corresponding values, 24-hour BP showed qualitative and quantitative differences; for example, it was considerably lower and higher than the guideline-corresponding values when office BP was in the high hypertension and low treatment target ranges, respectively.</p><p><strong>Conclusions: </strong>In treated patients with hypertension the slope of the office/24-hour BP linear regression is reproducible over time. However, the slopes are steeper in untreated individuals, indicating that information on ambulatory BP values corresponding to office BP values can be more accurate if separately estimated in these 2 conditions.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619266","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}
HypertensionPub Date : 2024-11-14DOI: 10.1161/HYPERTENSIONAHA.124.23497
Maria G Hauge, Peter Damm, Klaus F Kofoed, Emma Louise Ries Møller, Andrea G Lopez, Anne S Ersbøll, Marianne Johansen, Per E Sigvardsen, Michael H C Pham, Jens P Goetze, Andreas Fuchs, Jørgen T Kühl, Børge G Nordestgaard, Lars V Køber, Finn Gustafsson, Jesper J Linde
{"title":"Left Ventricular Hypertrophy in Women With a History of Preeclampsia.","authors":"Maria G Hauge, Peter Damm, Klaus F Kofoed, Emma Louise Ries Møller, Andrea G Lopez, Anne S Ersbøll, Marianne Johansen, Per E Sigvardsen, Michael H C Pham, Jens P Goetze, Andreas Fuchs, Jørgen T Kühl, Børge G Nordestgaard, Lars V Køber, Finn Gustafsson, Jesper J Linde","doi":"10.1161/HYPERTENSIONAHA.124.23497","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.23497","url":null,"abstract":"<p><strong>Background: </strong>As a hypertensive disorder of pregnancy, preeclampsia is associated with increased cardiovascular morbidity and mortality later in life. Since early signs of myocardial affection could indicate a higher risk of future cardiovascular disease manifestations, we investigated whether women with prior preeclampsia have a higher prevalence of left ventricular hypertrophy compared with women from the general population and to what extent chronic hypertension affects any potential difference.</p><p><strong>Methods: </strong>In a cohort study, women aged 40 to 55 years with prior preeclampsia were compared with age- and parity-matched women from the general population. They underwent a research cardiac computed tomography, and the primary outcome was left ventricular hypertrophy, defined as a left ventricular mass index >30 g/m<sup>2.7</sup>.</p><p><strong>Results: </strong>In 679 women with prior preeclampsia and 672 controls (median age, 47 years), we found a higher prevalence of left ventricular hypertrophy (14.0% versus 6.4%) in the preeclampsia group with an odds ratio of 1.62, 95% CI (1.07-2.46), <i>P</i>=0.024, median of 15 years (range, 0-28) after pregnancy, after adjustment for cardiovascular risk factors, including chronic hypertension. Left ventricular hypertrophy was more frequent among women with preeclampsia with (26.2% versus 15.6%) and without (5.5% versus 2.4%) chronic hypertension, and a mediation analysis showed that chronic hypertension explained 22% of the association between preeclampsia and left ventricular hypertrophy.</p><p><strong>Conclusions: </strong>Women with prior preeclampsia had a 2-fold higher prevalence of left ventricular hypertrophy compared with women from the general population, and preeclampsia was independently associated with left ventricular hypertrophy, regardless of the presence of cardiovascular risk factors, including chronic hypertension.</p><p><strong>Registration: </strong>URL: https://www.clinicalTrials.gov; Unique identifier: NCT03949829.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619262","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}
HypertensionPub Date : 2024-11-14DOI: 10.1161/HYPERTENSIONAHA.123.22353
Dawei Zhu, Jie Huang, Yujie Wu, Lin Fan, Yijun Liu, Qianwen Zhang, Li Li, Jian Han, Xinghui Liu
{"title":"Irisin Improves Preeclampsia by Promoting Embryo Implantation and Vascular Remodeling.","authors":"Dawei Zhu, Jie Huang, Yujie Wu, Lin Fan, Yijun Liu, Qianwen Zhang, Li Li, Jian Han, Xinghui Liu","doi":"10.1161/HYPERTENSIONAHA.123.22353","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.123.22353","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is a pregnancy-specific disorder with unclear pathogenesis. Irisin, a recently identified exercise-induced factor, significantly influences lipid metabolism and cardiovascular function. Nonetheless, its role in trophoblast development during human placentation and the related intracellular signaling pathways remain poorly understood.</p><p><strong>Methods: </strong>We assessed peripheral blood irisin expression in early pregnancy among patients with preeclampsia and its correlation with key clinical indicators. In trophoblast cell lines and mice, we used exogenous irisin and viral knockdown to investigate functional changes. Phosphorylation-specific antibody arrays and dual-luciferase reporter assays were used to explore downstream molecular mechanisms, which were subsequently validated in trophoblast cell lines and relevant gene knockout mice.</p><p><strong>Results: </strong>In early pregnancy, patients with preeclampsia exhibit decreased peripheral blood irisin levels, occurring earlier than traditional predictive markers, such as PLGF (placental growth factor) and sFlt-1 (soluble fms-like tyrosine kinase-1). Furthermore, irisin concentration is positively correlated with proteinuria and abnormal blood pressure during pregnancy. Exogenous irisin significantly enhanced trophoblast cell migration, invasion, and proliferation while inhibiting apoptosis. It also increased STAT (signal transducers and activators of transcription) 4 phosphorylation and its binding to the GLUT (glucose transporter)-3 promoter, resulting in elevated GLUT-3 expression and glucose uptake in trophoblast cells. In vivo, increased peripheral irisin promoted embryo implantation, vascular remodeling, and enhanced glucose uptake, whereas reduced irisin resulted in a preeclampsia-like phenotype characterized by elevated blood pressure, proteinuria, renal-placental dysfunction, adipose accumulation, and restricted fetal growth.</p><p><strong>Conclusions: </strong>Peripheral irisin improves preeclampsia by promoting embryo implantation and vascular remodeling through the activation of the STAT4/GLUT-3 pathway. Reduced peripheral irisin may contribute to preeclampsia-like pathologies. This study supports the advocacy for appropriate exercise during early pregnancy and provides new insights for preeclampsia prevention.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619260","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}
HypertensionPub Date : 2024-11-13DOI: 10.1161/HYPERTENSIONAHA.124.23695
Katlyn E McGraw, Arce Domingo-Relloso, Daniel W Riggs, Danielle N Medgyesi, Raghavee Neupane, Jeanette A Stingone, Tiffany R Sanchez
{"title":"Exposure to Volatile Organic Compounds and Blood Pressure in NHANES 2011 to 2018.","authors":"Katlyn E McGraw, Arce Domingo-Relloso, Daniel W Riggs, Danielle N Medgyesi, Raghavee Neupane, Jeanette A Stingone, Tiffany R Sanchez","doi":"10.1161/HYPERTENSIONAHA.124.23695","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.23695","url":null,"abstract":"<p><strong>Background: </strong>Volatile organic compounds (VOCs) are ubiquitous environmental pollutants. Exposure to VOCs is associated with cardiovascular disease risk factors, including elevated blood pressure in susceptible populations. However, research in the general population, particularly among nonsmoking adults, is limited. We hypothesized that higher VOC exposure is associated with higher blood pressure and hypertension, among nonsmokers.</p><p><strong>Methods: </strong>We included 4 cycles of data (2011-2018) of nonsmoking adults (n=4430) from the National Health and Nutrition Examination Survey. Urinary VOC metabolites were measured by ultraperformance liquid chromatography-mass spectrometry, adjusted for urine dilution, and log-transformed. We estimated mean differences in blood pressure using linear models and prevalence ratio of stage 2 hypertension using modified Poisson models with robust standard errors. Models were adjusted for age, sex, race and ethnicity, education, body mass index, estimated glomerular filtration rate, and National Health and Nutrition Examination Survey cycle.</p><p><strong>Results: </strong>Participants were 54% female, with a median age of 48 years, 32.3% had hypertension, and 7.9% had diabetes. The mean differences (95% CI) in systolic blood pressure were 1.61 (0.07-3.15) and 2.46 (1.01-3.92) mm Hg when comparing the highest with the lowest quartile of urinary acrolein (N-acetyl-S-[2-carboxyethyl]-L-cysteine) and 1,3-butadiene (N-acetyl-S-[3,4-dihydroxybutyl]-L-cysteine) metabolites. The prevalence ratios for hypertension were 1.06 (95% CI, 1.02-1.09) and 1.05 (95% CI, 1.01-1.09) when comparing the highest with lowest quartiles of urinary acrolein (N-acetyl-S-[2-carboxyethyl]-L-cysteine) and 1,3-butadiene (N-acetyl-S-[3,4-dihydroxybutyl]-L-cysteine), respectively.</p><p><strong>Conclusions: </strong>Exposure to VOCs may be a relevant yet understudied environmental contributor to cardiovascular disease risk in the nonsmoking, US population.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619256","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}
HypertensionPub Date : 2024-11-13DOI: 10.1161/HYPERTENSIONAHA.124.22068
Daria V Ilatovskaya, Amanda Behr, Alexander Staruschenko, Gentzon Hall, Oleg Palygin
{"title":"Mechanistic Insights Into Redox Damage of the Podocyte in Hypertension.","authors":"Daria V Ilatovskaya, Amanda Behr, Alexander Staruschenko, Gentzon Hall, Oleg Palygin","doi":"10.1161/HYPERTENSIONAHA.124.22068","DOIUrl":"10.1161/HYPERTENSIONAHA.124.22068","url":null,"abstract":"<p><p>Podocytes are specialized cells within the glomerular filtration barrier, which are crucial for maintaining glomerular structural integrity and convective ultrafiltration. Podocytes exhibit a unique arborized morphology with foot processes interfacing by slit diaphragms, ladder-like, multimolecular sieves, which provide size and charge selectivity for ultrafiltration and transmembrane signaling. Podocyte dysfunction, resulting from oxidative stress, dysregulated prosurvival signaling, or structural damage, can drive the development of proteinuria and glomerulosclerosis in hypertensive nephropathy. Functionally, podocyte injury leads to actin cytoskeleton rearrangement, foot process effacement, dysregulated slit diaphragm protein expression, and impaired ultrafiltration. Notably, the renin-angiotensin system plays a pivotal role in podocyte function, with beneficial AT2R (angiotensin receptor 2)-mediated nitric oxide (NO) signaling to counteract AT1R (angiotensin receptor 1)-driven calcium (Ca<sup>2+</sup>) influx and oxidative stress. Disruption of this balance contributes significantly to podocyte dysfunction and drives albuminuria, a marker of kidney damage and overall disease progression. Oxidative stress can also lead to sustained ion channel-mediated Ca<sup>2+</sup> influx and precipitate cytoskeletal disorganization. The complex interplay between GPCR signaling, ion channel activation, and redox injury pathways underscores the need for additional research aimed at identifying targeted therapies to protect podocytes and preserve glomerular function. Earlier detection of albuminuria and podocyte injury through routine noninvasive diagnostics will also be critical in populations at the highest risk for the development of hypertensive kidney disease. In this review, we highlight the established mechanisms of oxidative stress-mediated podocyte damage in proteinuric kidney diseases, with an emphasis on a hypertensive renal injury. We will also consider emerging therapies that have the potential to selectively protect podocytes from redox-related injury.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619264","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}
HypertensionPub Date : 2024-11-11DOI: 10.1161/HYPERTENSIONAHA.124.21724
Zdenka Pausova, Johanne Tremblay, Pavel Hamet
{"title":"Genetics of Hypertension: Additive and Interactive Effects.","authors":"Zdenka Pausova, Johanne Tremblay, Pavel Hamet","doi":"10.1161/HYPERTENSIONAHA.124.21724","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.21724","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619258","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}