Hypertension最新文献

{"title":"PHD2 Deletion in CD8+ T Cells Worsens TAC-Induced Cardiac Inflammation, Heart Failure, and Pulmonary Remodeling.","authors":"Lihong Pan,Xiaochen He,Rui Xu,Umesh Bhattarai,Dongzhi Wang,Hao Wang,Ziru Niu,Heng Zeng,John Clemmer,Josh Speed,Jian-Xiong Chen,Yingjie Chen","doi":"10.1161/hypertensionaha.125.25284","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.25284","url":null,"abstract":"BACKGROUNDCardiac inflammation is a key driver of cardiac fibrosis and heart failure. Cytotoxic CD8⁺ T cells play important roles in modulating inflammatory responses, especially during infections and autoimmune diseases. HIFs (hypoxia-inducible factors) regulate CD8⁺ T cell function and cardiac remodeling. However, the role of HIF in CD8⁺ T cells during heart failure development remains unclear.METHODSWe generated CD8⁺ T cell-specific PHD2 (prolyl hydroxylase domain protein 2)-deficient mice (PHD2CKO), in which HIF bioavailability is increased due to the loss of PHD2. PHD2CKO and wild-type littermates were subjected to pressure overload via transverse aortic constriction. Cardiac function, inflammation, and CD8⁺ T cell responses were assessed. CD8⁺ T cell metabolism was analyzed using Seahorse assays to measure extracellular acidification rate and oxygen consumption rate. HIF1α and HIF2α protein levels were measured by Western blotting.RESULTSUnder baseline conditions, PHD2 deletion in CD8⁺ T cells had no effect on heart function or effector molecule expression. Following transverse aortic constriction, PHD2CKO mice showed exacerbated cardiopulmonary inflammation, fibrosis, and dysfunction. These effects were associated with enhanced CD8⁺ T cell activation and cytokine production. In vitro, PHD2-deficient CD8⁺ T cells exhibited increased glycolysis (extracellular acidification rate), reduced oxidative phosphorylation (oxygen consumption rate), and elevated HIF1α-but not HIF2α-levels. Pharmacological inhibition of HIF1α, but not HIF2α, reversed these metabolic and functional changes.CONCLUSIONSPHD2 deletion in CD8⁺ T cells aggravates cardiopulmonary remodeling after pressure overload by enhancing CD8⁺ T cell activation and cytokine release via a HIF1α-dependent mechanism.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"35 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071760","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":"Expected Impact of Implementing the PAHO Regional Sodium Targets in Mexico.","authors":"Karla Muciño-Sandoval,Rodrigo Zepeda-Tello,Nancy López-Olmedo,Dalia Stern,Lizbeth Tolentino-Mayo,Jorge Vargas-Meza,Kamara Pather,Josiemer Mattei,Juan A Rivera,Ismael Campos-Nonato,Tonatiuh Barrientos-Gutierrez,Ana Basto-Abreu","doi":"10.1161/hypertensionaha.124.24021","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24021","url":null,"abstract":"BACKGROUNDExcessive sodium intake increases the risk of cardiovascular disease. Mexico has implemented voluntary measures to reduce sodium intake, but they are insufficient to meet the global target of sodium intake reduction by 2025. We aimed to simulate the expected impact of implementing the Pan American Health Organization Sodium Targets in processed and ultra-processed foods in Mexico.METHODSSodium consumption was estimated using 24-hour dietary recall data from the 2016 Mexican National Health and Nutrition Survey. The intervention consisted of implementing Pan American Health Organization Sodium Targets in 16 food groups divided into 75 subgroups. We estimated the potential decrease in systolic blood pressure using a linear function by age and hypertension status, and the potential decrease in deaths and incident cases of cardiovascular disease, chronic kidney disease, and stomach cancer using a nonparametric version of the potential impact fraction.RESULTSImplementing the Pan American Health Organization Sodium Targets could reduce overall sodium consumption by 25%, leading to a 1.2 mm Hg reduction in systolic blood pressure (2.1 mm Hg in people with hypertension). Annually, this intervention could prevent 5.3% of deaths (12 866 in 2019) and 3.9% of incident cases (43 940 in 2019) of cardiovascular disease, chronic kidney disease and stomach cancer.CONCLUSIONSImplementing the Pan American Health Organization Sodium Targets is expected to reduce sodium consumption and improve cardiovascular-related outcomes. Interventions in real-life settings, testing this premise should consider barriers and facilitators for implementation and maintenance, considering consumer preferences and fluctuations in food content.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"65 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068390","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":"Targeting IL-16 to Protect Angiotensin II-induced Hypertension and Renal Injury.","authors":"Wu-Wei Rong,Yi-Hang Yang,Qian-Wan Deng,Xiao-Hui Chen,Zi-Qi Xu,Meng-Yao Li,Jia-Jia Zhao,Wen-Hui Zhai,Zhi-Wen Shang,Ping-Jin Gao,Xiao-Dong Li,Ji-Guang Wang","doi":"10.1161/hypertensionaha.125.25172","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.25172","url":null,"abstract":"BACKGROUNDT cells are critical in the pathogenesis of hypertension. IL (interleukin)-16 is primarily produced and secreted by T cells; however, its role in hypertension remains unclear.METHODSSerum samples from patients with hypertension were collected and analyzed using ELISA. A mouse model of Ang II (angiotensin II)-induced hypertension was established, and the role of IL-16 was investigated.RESULTSIL-16 expression was elevated in patients with hypertension and positively correlated with both systolic and diastolic blood pressure. In Ang II-induced hypertensive mice, IL-16 expression was significantly upregulated in serum, kidney, and aortic tissues. IL-16-neutralizing antibody reduced both systolic and diastolic blood pressure in response to Ang II. Histological analyses revealed that renal injury and vascular remodeling were attenuated after IL-16 neutralization. Mechanistically, T-cell-derived IL-16 enhanced CD4+ (cluster of differentiation 4) T helper 1 cell function and mediated crosstalk with macrophages to stimulate inflammatory responses via activation of NF-κB (nuclear factor kappa B) and MAPK (mitogen-activated protein kinase) pathways. Conditioned medium from macrophages primed with IL-16-treated T helper 1 cells promoted smooth muscle cell proliferation and exacerbated endothelial cell damage during hypertension progression.CONCLUSIONSCollectively, these findings indicate that T-cell-derived IL-16 exacerbates Ang II-induced hypertension and associated organ damage by promoting a T helper 1-macrophage-driven proinflammatory response.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"21 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068389","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":"Prenatal PM2.5 Exposure Induces Offspring Hypertension via Nrf2/NLRP3 Pathway.","authors":"Xinyuan Zhang,Boping Yang,Mengyuan Li,Xiaoxiao Guo,Yilin Li,Xiangqian Gao,Lei Zhang,Ningxiao Jiang,Shinan Zhang,Huishu Xu,Baolin Zhang,Yanlin Wang,Yingjiang Xu,Gaofeng Qin,Bin Liu,Ping Yi,Lei Han","doi":"10.1161/hypertensionaha.125.24874","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24874","url":null,"abstract":"BACKGROUNDAdverse factors during pregnancy can significantly increase the incidence of hypertension in adult offspring. Activation of the sympathetic nervous system is closely associated with the development and progression of hypertension.METHODSWe established a model of offspring hypertension induced by prenatal fine particulate matter exposure to evaluate the role of the sympathetic nervous system activation. Quantitative immunofluorescence and Western blot analysis were used to assess the levels of activated and inhibitory sympathetic neurons. The effects of the central and peripheral sympathetic nervous systems were evaluated using clonidine and renal sympathetic denervation. In addition, the activation of microglia in the lateral ventricle region and the expression of the Nrf2 (nuclear factor E2-related factor)/ NLRP3 (NLR family pyrin domain-containing 3) signaling pathway were analyzed.RESULTSThe adult offspring showed increased neuronal hyperactivity and sympathetic nervous system activity. Specific inhibition of the central sympathetic nervous system and renal denervation effectively reversed the prenatal fine particulate matter-induced blood pressure elevation in adult offspring. In addition, overactivation of oxidative stress and microglia-mediated inflammation in the paraventricular nucleus was responsible for increased central sympathetic activity in the adult offspring exposed to prenatal fine particulate matter. Furthermore, we confirmed the critical role of the Nrf2/NLRP3 signaling pathway in oxidative stress and inflammation activation in the paraventricular nucleus of adult offspring.CONCLUSIONSOverall, prenatal fine particulate matter exposure induces excessive inflammation and oxidative stress in paraventricular nucleus microglia through the Nrf2/NLRP3 signaling pathway, resulting in central and peripheral sympathetic overactivation, leading to hypertension and left ventricular hypertrophy.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"188 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068391","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":"sFlt-1/PlGF Ratio Predicts Short-Term Maternal-Fetal Outcomes in Chinese Hypertensive Pregnancies: A Prospective Cohort Study.","authors":"Jiawei Tang,Di Xiao,Shujing Yang,Liujia Fang,Huanyao Liu,Dunjin Chen,Fang He","doi":"10.1161/hypertensionaha.125.25022","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.25022","url":null,"abstract":"BACKGROUNDThe sFlt-1 (soluble fms-like tyrosine kinase 1) and PlGF (placental growth factor) ratio holds significant value in the early identification of preeclampsia and risk stratification. However, its application within the Chinese population remains under-researched. This study evaluates the predictive performance of the sFlt-1/PlGF ratio in hospitalized Chinese patients with hypertensive disorders of pregnancy.METHODSThis prospective single-center cohort study (December 2023-June 2024) enrolled East Asian women aged ≥18 years with singleton pregnancies (23 weeks to 36 weeks and 6 days of gestation) and signs or symptoms of hypertensive disorders of pregnancy. A serum sFlt-1/PlGF level of 38 was selected as the critical value to differentiate risk levels. Maternal outcomes and fetal parameters were assessed within 2 weeks post-enrollment and statistically analyzed.RESULTSThe study included 132 hospitalized patients with hypertensive disorders of pregnancy, among whom 44 (33.3%) had an sFlt-1/PlGF ratio ≥38. The interval to delivery detected in the high-ratio group was significantly shorter (0.8 weeks compared with 4 weeks; P<0.001), and the risk of delivery within 2 weeks after detection was significantly increased (adjusted hazard ratio, 5.36 [95% CI, 3.42-8.39]; P<0.001). The sFlt-1/PlGF ≥38 had an area under the curve of 0.88 for predicting delivery within 2 weeks. This indicator also demonstrated good negative predictive performance in excluding maternal-fetal adverse outcomes (negative predictive values: severe preeclampsia, 0.93; severe small for gestational age, 0.93).CONCLUSIONSThe sFlt-1/PlGF ratio demonstrates strong predictive value for short-term delivery in hospitalized hypertensive disorders of pregnancy patients in China. Its high negative predictive value is particularly useful in excluding the risk of maternal-fetal adverse outcomes.REGISTRATIONURL: https://www.medicalresearch.org.cn; Unique identifier: MR-44-23-049132.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"53 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059071","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":"Modulating Placental Functionality in Preeclampsia With siRNA Nanocomplexes.","authors":"Xue Peng,Xi Tan,Li Dai,Wei Xia,Zhao Wu","doi":"10.1161/hypertensionaha.124.24291","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24291","url":null,"abstract":"BACKGROUNDEarly-onset preeclampsia poses significant risks to maternal and fetal health, necessitating a deeper understanding of its molecular mechanisms and effective therapeutic strategies.METHODSUtilizing data from genome-wide association study and Mendelian randomization analysis, we investigated the relationship between mitochondrial DNA copy number and preeclampsia. Transcriptome sequencing, in vitro experiments, and animal studies were conducted to explore the roles of SENP3 and SETD7 in preeclampsia pathogenesis. The development and evaluation of siRNA SENP3 delivered by DMD@DPF nanoparticles as a potential therapeutic intervention were also performed.RESULTSOur findings revealed a negative correlation between mitochondrial DNA copy number and preeclampsia, significant differential expression of SENP3 and SETD7 in preeclampsia placentas, and the therapeutic effects of siRNA SENP3 delivered by DMD@DPF nanoparticles on physiological parameters in a preeclampsia mouse model.CONCLUSIONSThis study highlights the crucial involvement of SENP3 and SETD7 in preeclampsia pathophysiology and proposes siRNA SENP3 delivered by DMD@DPF nanoparticles as a promising therapeutic approach for preeclampsia treatment.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"40 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032098","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":"Season of Blood Pressure Measurement Screening and All-Cause Mortality: A Community-Based Prospective Cohort Study.","authors":"Qinghua Yan,Fei Wu,Duolao Wang,Yuheng Wang,Qinping Yang,Mengyan Wang,Wenli Xu,Rong Yu,Minna Cheng,Yan Shi,Jiguang Wang","doi":"10.1161/hypertensionaha.125.25157","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.25157","url":null,"abstract":"BACKGROUNDThe association between season of screening blood pressure (BP) measurement and adverse outcomes has not been examined among populations without prior physician-diagnosed hypertension. We aimed to investigate the association between the season of screening clinic BP measurement and the risk of all-cause mortality.METHODSThis was a prospective cohort study, and data were analyzed from an ongoing community hypertension screening program in Shanghai between 2018 and 2024. In this study, 166 670 participants aged 35 to 89 years who were free of prior physician-diagnosed hypertension were included and had their BP measured with an automated office BP platform in Shanghai community health centers. Participants were categorized into 4 groups by season of screening BP measurement: spring, summer, autumn, and winter. Deaths were ascertained from linkage to the Shanghai Vital Statistics Registry with follow-up until September 30, 2024. Cox regression models were used to examine the association between seasons of BP measurement and risk of all-cause mortality.RESULTSDuring a median follow-up of 1.6 years, 1850 (1.1% of participants) all-cause deaths occurred. The incidence rate of all-cause mortality was 5.0 per 1000 person-years and was higher in participants with screening BP measured in summer (5.4 per 1000 person-years) than in other seasons (4.4, 5.3, and 4.9 per 1000 person-years in spring, autumn, and winter, respectively). After adjustment for age, sex, residential region, and systolic and diastolic BP, the hazard ratio for the risk of all-cause mortality in participants with screening BP measured in summer relative to the overall population was 1.14 (95% CI, 1.05-1.24). There was no any significant interaction between the season of screening BP measurement and sex, age, and hypertension status in relation to the risk of all-cause mortality (all P≥0.05).CONCLUSIONSScreening for raised BP in summer was associated with significantly higher risks of all-cause mortality, though the mean systolic/diastolic BP was lowest in summer. The findings imply that if only clinic BP is measured for hypertension screening in 4-season countries and regions, repeated BP measurements, preferably in different seasons, might be needed.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"21 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032097","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":"Geometric Aging of the Thoracic Aorta: Insights From 2 Large Cohorts.","authors":"Cameron Beeche,Hamed Tavolinejad,Bingxin Zhao,Patrick Segers,Jeffrey Duda,James Gee,Walter R Witschey, ,Julio A Chirinos","doi":"10.1161/hypertensionaha.125.25259","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.25259","url":null,"abstract":"BACKGROUNDAortic structural degeneration occurs with aging; however, 3-dimensional geometric remodeling has not been well characterized in large populations.METHODSWe segmented the thoracic aorta from magnetic resonance images of 56 164 UKB (UK Biobank) participants and computed tomography images of 9417 PMBB (Penn Medicine Biobank) participants. We quantified structural measurements of elongation, dilation, tortuosity, and curvature across the thoracic aorta. Multivariate linear regression models estimated the associations between age and aortic structure in a subset of normative healthy participants from the UKB (n=3532), and in the overall cohorts.RESULTSPatterns of aging were highly consistent between the UKB and PMBB. In the UKB normative subset, aging was associated with profound geometric changes, including elongation (β per decade of age, 1.001 cm [95% CI, 0.893-1.110]; P<0.0001), luminal dilation (β per decade of age, 0.870 mm [95% CI, 0.794-0.947]; P<0.0001), and decreased curvature (β per decade of age, -0.060 mm-1 [95% CI, -0.067 to -0.053]; P<0.0001). The strongest relationship with age was observed for aortic volume (β per decade of age, 17.124 mL [95% CI, 15.124-18.386]; P<0.0001). No age-sex interactions were observed in the healthy normative subset, whereas in the overall UKB and PMBB cohorts, females exhibited less pronounced luminal dilation (particularly after menopause) and more pronounced changes in curvature.CONCLUSIONSAging is associated with profound 3-dimensional geometric changes in the thoracic aorta, including elongation, luminal dilation, and decreased curvature. Females demonstrate less eccentric aortic remodeling and more pronounced changes in curvature, likely contributing to unfavorable pulsatile arterial hemodynamics that are present in older females.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"29 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032153","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":"Poor Accuracy of Blood Pressure Measurement Images Online: Implications for Public Health Education.","authors":"Leopold Ndemnge Aminde,Fakir M Amirul Islam,Victoria E Cheng,Christina Saad,Yanni Li,Aletta E Schutte","doi":"10.1161/hypertensionaha.125.25064","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.25064","url":null,"abstract":"BACKGROUNDBlood pressure (BP) is a common clinical measurement, now increasingly done at home. Media websites often display images of BP measurement to represent clinical medicine, but many images deviate from guidelines, potentially creating misperceptions on how measurement should be performed. We evaluated the accuracy of BP measurement images online according to the 2023 International Consensus on Standardized Clinic BP Measurement.METHODSWe evaluated the first ≈100 images from each of 11 major stock photo websites. Two independent reviewers assessed each image, resolving disagreements through discussion. Only visible accuracy aspects were scored.RESULTSOnly 14% of images (N=1106) were accurate on all criteria, ranging from 7% at Flickr and Freepik to 28% at iStock. Photo settings included 63% clinical and 37% home-based; 73% by healthcare providers, 24% by patients, and 3% other settings. Images were penalized for the following guideline deviations: back unsupported (73%), forearm not resting on a surface (55%), manual and not electronic device (52%), feet not flat on the floor (36%), doctor or observer talking/laughing (23%), mid-arm not at heart level (19%), patient talking/laughing (18%), legs crossed (13%), cuff on clothing (12%), and patient not sitting (5%). Accuracy levels differed by setting (clinical 8% versus home 25%, P<0.001) and assessors (self 35%, healthcare provider 7%, and other people 13%; P<0.001).CONCLUSIONSOnly 1 in 7 online stock photo images of BP measurement align with clinical guidelines. Media houses, website developers, and the public should be educated on appropriate measurement techniques to ensure accurate BP measurement in the clinic and at home.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"12 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017870","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 Blood Pressure Self-Management on Vascular Remodeling After Hypertensive Pregnancy.","authors":"Jamie Kitt,Luca Biasiolli,Samuel Krasner,Paul A Bateman,Hannah Cutler,Logan Barr,Annabelle Frost,Katherine Tucker,Katie Suriano,Yvonne Kenworthy,Winok Lapidaire,Miriam Lacharie,Rebecca Mills,Cristian Roman,Lucy Mackillop,Christina Aye,Alexandra Cairns,Basky Thilaganathan,Lucy C Chappell,Adam J Lewandowski,Richard J McManus,Paul Leeson","doi":"10.1161/hypertensionaha.125.24854","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24854","url":null,"abstract":"BACKGROUNDHypertensive pregnancy disorders are associated with long-term adverse cardiac and vascular remodeling postindex pregnancy. The POP-HT trial (Physician Optimised Postpartum Hypertension Treatment) demonstrated that improved puerperal blood pressure control leads to reduced blood pressure and beneficial cardiac remodeling during the first year postpartum. This study describes the impact on postpartum vascular remodeling.METHODSA prospective, randomized, open-label, blinded end point trial in a single UK hospital where 220 women were assigned 1:1 to intervention (self-management via physician-guided antihypertensive titration) or control (usual postnatal care via primary care doctor±midwife). Eligible participants were ≥18 years, with preeclampsia or gestational hypertension and requiring antihypertensives on discharge. Prespecified secondary vascular outcomes included aortic blood pressure and pulse wave velocity measured by Vicorder at baseline and 9 months postpartum, and additional cardiovascular magnetic resonance measures of aortic distensibility were performed.RESULTSThere were no baseline differences in aortic blood pressure or pulse wave velocity but by 9 months postpartum, aortic diastolic blood pressure was -5.2 mm Hg lower ([95% CI, -8.0 to -2.2]; P<0.001), and pulse wave velocity was -0.71 m/s lower ([95% CI, -1.42 to -0.006]; P=0.048) in the intervention arm compared with the control arm, which corresponded with greater aortic distensibility by 0.78×10-3 mm Hg-1 ([95% CI, -0.01 to 1.55]; P=0.046).CONCLUSIONSPostpartum blood pressure self-monitoring combined with physician-guided medication titration is associated with reduced central arterial stiffness during the first year after a hypertensive pregnancy, in addition to the previously demonstrated effects on blood pressure and cardiac remodeling.REGISTRATIONURL: https://www.clinicaltrials.gov; Unique identifier: NCT04273854.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"36 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962646","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}