Hypertension最新文献

{"title":"Daily Versus BID Nifedipine GITS in Severe Preeclampsia: Randomized Controlled Trial.","authors":"Miranda K Kiefer,Hayley Williams,Oluchi Nwosu,Devra D Doan Mast,Maged M Costantine,Kara M Rood","doi":"10.1161/hypertensionaha.124.24532","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24532","url":null,"abstract":"BACKGROUNDOptimal dosing of nifedipine gastrointestinal therapeutic system (GITS) in pregnancies complicated by preeclampsia with severe features is unknown. We assessed whether nifedipine GITS 30 mg BID improved blood pressure control when compared with nifedipine GITS 60 mg daily.METHODSUnblinded, randomized controlled trial, at a single academic hospital from December 2021 to December 2023. Individuals between 220/7 and 335/7 weeks of gestation diagnosed with preeclampsia with severe features were randomized to nifedipine GITS 60 mg QD or 30 mg BID once the decision to increase the total daily dose was made. The primary outcome was the percentage of suboptimal blood pressures on hours 24 to 48 after randomization, defined as the ratio of systolic ≥150 mm Hg and diastolic ≥100 mm Hg blood pressure episodes divided by the total number of blood pressures taken during the collection time period.RESULTSThe percentage of suboptimal blood pressure from hours 24 to 48 was similar between groups (60 mg daily: 34.2±29.4% versus 30 mg BID: 32.8±34.0%; P=0.87). The need for any emergent antihypertensive treatment during the blood pressure collection period was higher in the 60 mg daily group (46.2% versus 14.8%; P=0.03). Secondary outcomes including gestational age at delivery and number of increases in long-acting antihypertensive regimen were similar.CONCLUSIONSNifedipine GITS dosed 60 mg daily and 30 mg BID has similar rates of suboptimal blood pressure in individuals with preeclampsia with severe features. However, there is a reduction in the need for emergent antihypertensive treatment for severe range blood pressures with BID dosing, which would favor its use in this population.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"18 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103779","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":"Cardiac Structure, Function and Mechanics in Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis.","authors":"Jamie J Edwards,Veronica Giorgione,Megan Griffiths,Claire Compton,Evelyn Greenhough,Elliot Smith,Eliane Cunliffe,Navazh Jalaludeen,Thomas Yates,Claire Meek,Joseph Cheriyan,Anna Marciniak,Baskaran Thilaganathan,Rajan Sharma,Jamie M O'Driscoll","doi":"10.1161/hypertensionaha.124.24472","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24472","url":null,"abstract":"BACKGROUNDHypertensive disorders of pregnancy (HDP) are among the most common pregnancy complications and leading causes of maternal morbidity and mortality worldwide. This study aimed to perform the largest meta-analysis to date comparing conventional and advanced echocardiographic features in HDP against healthy pregnancy.METHODSPubMed (MEDLINE) and EMBASE were systematically searched for research articles published up to March 2024. Included studies reported at least 1 relevant echocardiographic parameter in pregnancies complicated by HDP and normotensive healthy pregnancies separately. A total of 53 studies met the inclusion criteria, comprising 7168 participants (3381 HDP and 3787 controls).RESULTSMyocardial mechanics, as measured by global longitudinal strain (weighted mean difference (WMD), -2.81% [95% CI, -3.70 to -1.91]; P<0.001) and left atrial reservoir strain (WMD, -9.36% [95% CI, -12.73 to -5.99]; P<0.001), were significantly impaired in HDP compared with healthy pregnancy. Furthermore, there were prominent cardiac structural differences, with significantly greater left ventricular mass index (WMD, 12.20 [95% CI, 9.77-14.64]; P<0.001), relative wall thickness (WMD, 0.055 [95% CI, 0.04-0.07]; P<0.001), left atrial size (WMD, 2.34 cm [95% CI, 1.62-3.06]; P<0.001), and left atrial volume index (WMD, 2.38 mL/m2 [95% CI, 1.44-3.32]; P<0.001) in HDP compared with healthy pregnancy. Finally, the ratio between early mitral inflow velocity and early mitral annular velocity average was significantly greater in HDP (WMD, 1.90 [95% CI, 1.42-2.38; P<0.001), indicative of an elevated left ventricular filling pressure.CONCLUSIONSThis meta-analysis highlights clinically relevant differences in echocardiographic measures between HDP and healthy pregnancy. These results may enhance the utilization of echocardiography for the risk stratification and management of women with HDP. Advanced myocardial mechanics, including global longitudinal strain and left atrial reservoir strain, likely play a key role in detecting subclinical myocardial dysfunction and guidance for early intervention.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"20 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945406","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":"Hypertension: An Update from the Editor-in-Chief.","authors":"Rhian M Touyz","doi":"10.1161/hypertensionaha.125.25068","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.25068","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"141 1","pages":"927-928"},"PeriodicalIF":8.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982440","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":"Establishing Reference Values for Pulse Wave Velocity in Young People.","authors":"Vimarsha Kodithuwakku,Monique Breslin,Jeanne Hersant,Rosa-Maria Bruno,Pierre Boutouyrie,Elaine M Urbina,Seana Gall,Rachel E Climie,","doi":"10.1161/hypertensionaha.125.25007","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.25007","url":null,"abstract":"BACKGROUNDAortic pulse wave velocity (PWV) is an indicator of vascular aging and has proven to be effective in adult cardiovascular risk assessment. To use it in young people to identify those who may be at increased cardiovascular disease risk, reference values need to be determined. The Youth Vascular Consortium is a large, international database which was established to investigate vascular aging in youth. Using data from the Youth Vascular Consortium, this study aimed to develop reference values for aortic PWV in healthy young people.METHODSThis is a retrospective, multicenter study. Data on demographics, anthropometric, biochemical, and vascular aging measures from participants aged 1 year to 40 years were harmonized. Generalized additive models were used to derive percentile curves for PWV and predicted percentiles at years of age were reported by sex, continent, and device.RESULTSData from 19 930 participants (mean age=17 years, 51% female, 71% European), classified as healthy based on blood pressure, body mass index, serum glucose, and cholesterol levels, were included to construct the reference values. Six devices were used to assess aortic PWV (29% SphygmoCor). Device-specific percentile curves for aortic PWV were constructed, and an increasing trend was identified for both sexes with age.CONCLUSIONSThis study provided reference values for aortic PWV assessed with 6 devices for healthy young people by age and sex. These percentiles may be applied clinically to identify youth with impaired vascular aging and, thus, those who may be at risk of developing overt cardiovascular disease in the future.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"3 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945390","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":"Direct-to-Consumer Facilitation of PA Testing: A Bold Start But More Work Remains.","authors":"Alexander A Leung,Gregory Kline","doi":"10.1161/hypertensionaha.125.24793","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24793","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"123 1","pages":"989-991"},"PeriodicalIF":8.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982449","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":"Cell Type-Resolved Transcriptome of Aldosterone-Induced Atrial Myopathy and Arrhythmia.","authors":"David Meral,Argen Mamazhakypov,Katharina Juncker,Marbely Calderón-Fernández,Rémi Peyronnet,Callum Zgierski-Johnston,Sebastian Preissl,Achim Lother","doi":"10.1161/hypertensionaha.125.24609","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24609","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"14 1","pages":"e105-e107"},"PeriodicalIF":8.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982450","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":"Early Pregnancy Blood Pressure Trajectories and Hypertension Years After Pregnancy.","authors":"James M Roberts, Stacey E Alexeeff, Baiyang Sun, Mara Greenberg, Alexis King, Mai N Nguyen-Huynh, Alan S Go, Erica P Gunderson","doi":"10.1161/HYPERTENSIONAHA.125.24649","DOIUrl":"10.1161/HYPERTENSIONAHA.125.24649","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorders of pregnancy (HDP) increase cardiovascular disease risk. Blood pressure (BP) trajectories ≤20 weeks' gestation predict HDP outcomes. We hypothesized that early-pregnancy BP patterns stratify risk of developing hypertension years after pregnancy.</p><p><strong>Methods: </strong>This prospective cohort of 174 774 women without prior hypertension, kidney, liver, or heart disease, or history of preeclampsia entered prenatal care ≤14 weeks and delivered a stillborn or live singleton birth at Kaiser Permanente Northern California hospitals (2009-2019). Electronic health records provided data, including HDP for each birth, longitudinal outpatient clinical BP measurements, International Classification of Diseases codes, and medication use to identify new-onset hypertension from 2 months through 14 years post-delivery (2009-2023). Latent class trajectory modeling identified 6 BP trajectory (BPT) groups capturing both BP levels and slopes from 0 to 20 weeks' gestation. Multivariable Cox regression models estimated the hazard ratio (95% CIs) of new-onset hypertension after pregnancy associated with early-pregnancy BP trajectories, with effect modification by HDP.</p><p><strong>Results: </strong>BP trajectories were associated with an increasing gradient of hypertension risk after pregnancy within each HDP group. Adjusted hazard ratios were higher among preeclampsia and gestational hypertension groups than for no HDP. From lowest to highest BPT groups, hazard ratios ranged from 2.91 to 27.31 for preeclampsia, 4.20 to 27.81 for gestational hypertension, and 2.92 to 10.96 for no HDP compared with lowest BP trajectories of the no HDP group (all reference 1.0).</p><p><strong>Conclusions: </strong>Early-pregnancy BP trajectories are strongly associated with new-onset hypertension years after pregnancy. Combined with HDP, they may stratify risk for targeted surveillance and early interventions and improve the prediction of cardiovascular disease risk in women.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"e75-e87"},"PeriodicalIF":6.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763697","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":"Prenatal Psychosocial Stressors and Blood Pressure Across 4 Years Postpartum.","authors":"Noelle Pardo, Sandrah P Eckel, Zhongzheng Niu, Rima Habre, Tingyu Yang, Xinci Chen, Mario J Vigil, Brendan H Grubbs, Laila Al-Marayati, Nathana Lurvey, Claudia M Toledo-Corral, Jill Johnston, Genevieve Dunton, Carrie V Breton, Theresa M Bastain, Shohreh F Farzan","doi":"10.1161/HYPERTENSIONAHA.124.23979","DOIUrl":"10.1161/HYPERTENSIONAHA.124.23979","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial stress is a cardiovascular risk factor; however, little is known about whether prenatal psychosocial stressors influence postpartum cardiovascular health. We aimed to examine the associations of multiple measures of prenatal psychosocial stress on maternal blood pressure (BP) in the first 4 years after birth.</p><p><strong>Methods: </strong>Among 225 MADRES cohort (Maternal and Developmental Risks From Environmental and Social Stressors) participants, we examined associations of average prenatal Perceived Stress Scale (PSS), Center for Epidemiological Studies Depression (CES-D) scores, and second-trimester neighborhood social cohesion scores on systolic and diastolic BP collected at annual postpartum study visits (1-4 years) using linear mixed-effects models, adjusted for covariates.</p><p><strong>Results: </strong>Higher prenatal PSS and CES-D scores were associated with greater diastolic BP at 1 year postpartum (0.24 [95% CI, 0.01-0.46] and 0.24 [95% CI, 0.08-0.40] mm Hg per 1-unit higher PSS and CES-D, respectively) and greater systolic BP (0.25 [95% CI, 0.02-0.48] mm Hg per 1-unit higher CES-D). Overall associations of PSS and CES-D with BP were attenuated over the 4-year postpartum period (<i>P</i><0.05). Stratified analyses suggested larger associations of PSS and CES-D among US-born participants and participants with normotensive pregnancies. While neighborhood social cohesion was not associated with postpartum BP overall, higher neighborhood social cohesion scores were associated with lower BP at 1 year postpartum among participants with normotensive pregnancies and lower systolic BP among foreign-born Hispanic participants.</p><p><strong>Conclusions: </strong>Higher prenatal perceived stress and depressive symptoms were associated with greater 1-year postpartum BP, whereas neighborhood cohesion was associated with lower 1-year postpartum BP. These results suggest prenatal psychosocial factors may impact cardiovascular health within the first year after birth.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"849-858"},"PeriodicalIF":6.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382010","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":"Aspirin Improves Uterine Artery Function in Hypercholesterolemic Preeclampsia.","authors":"Amanda A de Oliveira, Floor Spaans, Murilo E Graton, Angie Stokes, Raven Kirschenman, Anita Quon, Christy-Lynn M Cooke, Sandra T Davidge","doi":"10.1161/HYPERTENSIONAHA.124.24435","DOIUrl":"10.1161/HYPERTENSIONAHA.124.24435","url":null,"abstract":"<p><strong>Background: </strong>Excessive hypercholesterolemia in pregnancy increases the risk of preeclampsia (HC-PE), though the mechanisms remain unclear. We recently showed that uterine artery function is impaired in HC-PE pregnancies via activation of the TLR4 (toll-like receptor 4)/PGHS1 (prostaglandin H synthase 1) pathway. Low-dose aspirin lowers preeclampsia risk in high-risk pregnancies by inhibiting PGHS1, but its effects in HC-PE pregnancies are not known. Moreover, oxidized low-density lipoprotein (oxLDL) levels rise in HC-PE, potentially activating TLR4 and LOX-1 (lectin-like oxLDL receptor-1; scavenger receptor linked to vascular dysfunction in preeclampsia). However, whether this occurs in HC-PE is not known.</p><p><strong>Methods: </strong>Sprague Dawley rats received a control or high-cholesterol diet (to induce HC-PE) from gestational day 6 to 20, with placebo or low-dose aspirin (1.5 mg/kg daily) given from gestational day 10 to 20. On gestational day 20, pregnancy outcomes and uterine artery function were assessed.</p><p><strong>Results: </strong>Uterine artery blood flow velocity and placental weights were higher in HC-PE placebo-treated dams versus controls, but these were reduced by low-dose aspirin. Endothelium-dependent vasodilation was impaired in the uterine arteries of the HC-PE placebo group versus controls and was corrected by low-dose aspirin. Ex vivo inhibition of TLR4, PGHS1, or LOX-1 also normalized endothelium-dependent vasodilation in the HC-PE placebo-treated dams. Exposure to oxLDL in the bath (modeling a secondary hit) further impaired endothelium-dependent vasodilation in the uterine arteries of the HC-PE placebo group, partially via TLR4 and LOX-1, which was prevented by low-dose aspirin.</p><p><strong>Conclusions: </strong>Low-dose aspirin improved uterine artery endothelial function in HC-PE pregnancies; likely by suppressing the TLR4/LOX-1/PGHS1 pathway.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"859-871"},"PeriodicalIF":6.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398881","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":"Epidemiology of Maternal Hypertensive Disorders.","authors":"Yan Zhao, Yue Wang, Fei Tong, Qianqian Gao, Baoxuan Li","doi":"10.1161/HYPERTENSIONAHA.124.23765","DOIUrl":"10.1161/HYPERTENSIONAHA.124.23765","url":null,"abstract":"<p><strong>Background: </strong>Maternal hypertensive disorders during pregnancy are a worldwide health problem, particularly in the countries/regions with low sociodemographic levels. This study aimed to reveal and predict the hypertensive disorders during pregnancy-related epidemiological trends.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease 2019 study, we constructed an age-period-cohort model to assess the net drift (annual percentage changes), associated age, period, and cohort effects across global and different sociodemographic index (SDI) regions. Moreover, we analyzed attributable risk factors and future trends based on the autoregressive integrated moving average model.</p><p><strong>Results: </strong>The numbers of hypertensive disorders during pregnancy worldwide increased by 10.9% (95% uncertainty interval, 6.1-15.3) from 1990 to 2019 and only increased in the low-SDI countries. The age-standardized incidence rate declined by 23.6% (20.6, 26.9), with a global net drift of -0.8%, whereas some higher-SDI countries showed a positive net drift. After controlling for period and cohort factors, the highest incidence was observed in the 20- to 29-year age group. The period and cohort effects showed decreasing trends, whereas unfavorable period effects occurred after 2010 in high-SDI and middle-high-SDI countries. High-income North America and western sub-Saharan Africa have shown increased numbers of disability-adjusted life years due to malnutrition. The autoregressive integrated moving average model revealed downward trends in the global incidence and age-standardized incidence rate by 2030.</p><p><strong>Conclusions: </strong>Our study highlights significant regional and national variations and age differences in the burden of hypertensive disorders during pregnancy associated with SDI stratification, which will facilitate the targeting of cost-effective health policy planning, resource allocation, and women's health management by policymakers.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"e88-e101"},"PeriodicalIF":6.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399052","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}