Hypertension最新文献

{"title":"Impact of NAFLD and Fibrosis on Adverse Cardiovascular Events in Patients With Hypertension.","authors":"Yanqiu Huang,Tingya Wan,Yuemei Hong,Xiaoyu Wang,Xu Jiang,Yang Yang,Hong Gao,Juan Ji,Liao Wang,Yang Yang,Xiaoguang Li,Hui Wang","doi":"10.1161/hypertensionaha.124.24252","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24252","url":null,"abstract":"BACKGROUNDNonalcoholic fatty liver disease (NAFLD) is a common comorbidity in hypertension. However, the impact of NAFLD and related fibrosis on hypertension and its control of cardiovascular disease (CVD) and mortality outcomes remains unclear.METHODS12 907 and 120 639 participants with hypertension were from the National Health and Nutrition Examination Survey (NHANES) and UK Biobank (UKBB), respectively. Mendelian randomization analyses explored the causal relationship among hypertension, NAFLD, and CVD. Cox regressions estimated the hazard ratios for CVD and mortality associated with NAFLD (defined by fatty liver index) and liver fibrosis (defined by fibrosis-4 index or NAFLD fibrosis score).RESULTSThe NHANES documented 3376 deaths over a median follow-up of 8.5 years, and the UKBB documented 15 864 deaths, 4062 incident ischemic strokes, and 5314 incident myocardial infarctions over a median follow-up of 13.5 years. The hazard ratios for CVD and mortality increased in accordance with NAFLD grading (ischemic stroke, 1.16 [95% CI, 1.01-1.33]; myocardial infarction, 1.64 [95% CI, 1.44-1.86] in UKBB; and all-cause mortality, 1.29 [95% CI, 1.09-1.54] in NHANES). High-risk fibrosis increased the hazard ratios for all-cause mortality by 91% and ischemic stroke by 42% in patients with NAFLD in UKBB and for all-cause mortality by 95% in NHANES. NAFLD partially mediates the risk of hypertension for incident CVD and mortality (NHANES, 6.45% of all-cause mortality; UKBB, 5.17% of all-cause mortality; and 8.20% of myocardial infarction).CONCLUSIONSNAFLD and related liver fibrosis are associated with a higher risk of incident CVD and mortality in hypertensives. NAFLD and related liver fibrosis seem to partially mediate hypertension-induced CVD and mortality.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"42 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866856","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":"MicroRNA-210 Mediates Hypoxic Pulmonary Hypertension in the Newborn Lamb.","authors":"Xiang-Qun Hu,Rui Song,Chiranjib Dasgupta,Stephen Twum-Barimah,Taiming Liu,Abu Ahmed,Shawn F Hanson,Lubo Zhang,Arlin B Blood","doi":"10.1161/hypertensionaha.124.23061","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.23061","url":null,"abstract":"BACKGROUNDPulmonary hypertension of the newborn is a life-threatening disorder characterized by elevated pulmonary vascular resistance due to maladaptation of the pulmonary circulation after birth. The etiology and mechanisms underlying pulmonary hypertension of the newborn remain unclear, hindering the development of effective treatment. We hypothesize that perinatal chronic hypoxia upregulates microRNA-210, which is essential for suppression of pulmonary arterial spontaneous transient outward currents (STOCs), resulting in pulmonary hypertension of the newborn.METHODSWe tested this hypothesis in a large animal model of pregnant sheep and newborn lambs exposed to chronic hypoxia by comparing loss- versus gain-of-function of microRNA-210.RESULTSChronic perinatal hypoxia increases pulmonary vascular resistance and pulmonary arterial pressure in newborn lambs. The effect was mainly mediated by hypoxia after birth in the newborn. Mechanistically, we showed a significant decrease in microRNA-210 in pulmonary arteries after birth, but newborn hypoxia abolished this birth-induced reduction. We found that microRNA-210 mimic suppressed STOCs in newborn pulmonary arteries, and knockdown of microRNA-210 by microRNA-210-LNA prevented the hypoxia-induced reduction of pulmonary arterial STOCs. In vivo loss-of-function and gain-of-function experiments reveal that microRNA-210 is essential in the hypoxia-induced suppression of pulmonary arterial STOCs, increased pulmonary vascular resistance, and pulmonary hypertension in newborn lambs. Mechanistically, microRNA-210 suppressed pulmonary arterial STOCs via downregulation of iron-sulfur cluster assembly enzyme and large-conductance Ca2+-activated K+ channels.CONCLUSIONSWe provide explicit evidence that neonatal hypoxia increases microRNA-210 expression, which is essential for suppression of STOCs, resulting in pulmonary hypertension in newborn lambs. Our study reveals new insights into the mechanisms and clinically meaningful targets for treatment of pulmonary hypertension of the newborn.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"6 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866855","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":"Effects of Blood Pressure Control on Arterial Stiffness Mechanisms in SPRINT: A Randomized Controlled Trial.","authors":"Ryan Pewowaruk,Byron C Jaeger,Timothy M Hughes,Bharathi Upadhya,Dalane W Kitzman,Mark A Supiano,Adam D Gepner","doi":"10.1161/hypertensionaha.124.24816","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24816","url":null,"abstract":"BACKGROUNDThe longitudinal impact of blood pressure (BP) control on the components of arterial stiffness has not been studied.METHODSThe SPRINT (Systolic BP Intervention Trial) compared an intensive systolic BP goal (<120 mm Hg) to a standard goal (<140 mm Hg). Carotid-femoral pulse wave velocity (PWV) was measured in a subset of participants (n=605) at 0, 1, 2, and 3 years after randomization. Structural stiffening due to remodeling of the vessel wall and load-dependent stiffening, from changes in BP, were calculated by adjusting PWV to a 120/80 mm Hg reference BP with participant-specific models. The effect of intensive BP control on BP and arterial stiffness components over time was evaluated using generalized least squares regression.RESULTSIntensive BP control slowed the progression of PWV (total stiffness) compared with standard BP control at 3-year follow-up (-0.49 [-0.02 to -0.96] m/s, P=0.042). Differences in total stiffness between treatment groups over 3 years of follow-up were driven by intensive BP control reducing load-dependent PWV (-0.71 [-0.58 to -0.85] m/s, P<0.001), not structural PWV (+0.20 [-0.26 to +0.66], P=0.40). Load-dependent PWV was lower in the intensive treatment group at 1 year and remained lower throughout the follow-up. In contrast, structural PWV was similar between the 2 groups and increased throughout the follow-up period.CONCLUSIONSIntensive BP control slowed the progression of total arterial stiffness by decreasing load-dependent stiffness, but not through reduced structural stiffness. Future investigations are needed to determine if load-dependent PWV may have potential utility as a biomarker to monitor the efficacy of treatment and guide BP management strategies.REGISTRATIONURL: https://www.clinicaltrials.gov; Unique identifier: NCT01206062.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"35 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862033","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":"Treatment in the First Month After Hypertension Diagnosis Improves Blood Pressure Control.","authors":"Robert B Barrett,Benjamin Riesser,Benjamin Martin,Neha Sachdev,Michael K Rakotz,Susan E Sutherland,Brent M Egan","doi":"10.1161/hypertensionaha.124.23508","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.23508","url":null,"abstract":"BACKGROUNDAdults with hypertension have fewer cardiovascular events if controlled within the first 6 months of diagnosis, during which time they are excluded from many hypertension control metrics. We compared blood pressure (BP, mm Hg) control rates from 6 to 42 months in adults with hypertension who did or did not have antihypertensive treatment initiated (TI) with monotherapy during the first month after diagnosis, irrespective of subsequent changes in antihypertensive pharmacotherapy.METHODSA retrospective cohort of 15 422 patients, mean age 56.0±14.8 years, from 5 health care organizations, was identified with previously undiagnosed and untreated hypertension. BP control (<140/<90) and TI on visits with uncontrolled readings were assessed as a function of time since diagnosis, up to 42 months. Logistic regression models provided estimates of the odds of TI for initial BP, stratified by race, sex, and diagnosed diabetes. Cox proportional hazards regression estimated the hazard ratio of BP control over time.RESULTSPatients with TI during the first month versus later time points had better BP control at 6 (57.7% versus 47.7%, P<0.001) through 30 months (66.8% versus 62.2%, P<0.001), with similar control rates thereafter.CONCLUSIONSTI within the first month after diagnosis in contrast to later time points, leads to better BP control at 6 to 30 months, which is associated with better clinical outcomes and performance on standard hypertension control metrics. While better control is sustained for 30 months, treatment with monotherapy during the first month following diagnosis was insufficient to control hypertension in >30% of patients.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"64 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857416","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":"IGF-1 Provides Protective Role in Arteriosclerotic Cerebral Small Vessel Disease.","authors":"Xiangming Xu,Ming Yi,Chi Xiao,Jing Yang,Jiayu Guo,Wenli Zhou,Kun Zhou,Liuting Hu,Linfang Lan,Yuhua Fan","doi":"10.1161/hypertensionaha.124.24341","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24341","url":null,"abstract":"BACKGROUNDHypertension and advanced age are risk factors for arteriosclerotic cerebral small vessel disease (cSVD), a common cause of vascular dementia in elderly individuals. Circulating IGF-1 (insulin-like growth factor 1) levels decrease with age and are linked to age-related cognitive impairment. This study assessed the relationship between serum IGF-1 and arteriosclerotic cSVD severity in patients and the therapeutic effects and underlying mechanisms of exogenous IGF-1 supplementation in a cSVD rat model.METHODSSerum and MR images were collected from healthy subjects (n=26) and patients with arteriosclerotic cSVD (n=86). Stroke-prone renovascular hypertensive rats were used as cSVD animal models and subjected to the Morris water maze test, magnetic resonance imaging, immunohistochemistry, and biochemical analysis. hCMEC/D3 cells were utilized to validate the underlying mechanisms in vitro.RESULTSSerum IGF-1 concentration was significantly reduced in patients and rats with arteriosclerotic cSVD. Lower serum IGF-1 was associated with an increased cSVD burden and cognitive impairment. Compared with cSVD rats, IGF-1-treated rats had lighter white matter lesions, greater global cerebral blood flow, greater cerebrovascular density, less blood-brain barrier leakage, and better cognitive function. In vitro, IGF-1 administration promoted endothelial proliferation, migration, tube formation, and barrier function. Mechanistically, IGF-1 exerts neuroprotective effects by activating the IGF-1R (IGF-1 receptor)/Wnt7b/β-catenin pathway in vivo and in vitro.CONCLUSIONSLow serum IGF-1 was associated with greater arteriosclerotic cSVD severity. IGF-1 treatment improved cerebral perfusion, blood-brain barrier integrity, and cognitive function in cSVD rats by activating the IGF-1R/Wnt7b/β-catenin pathway, suggesting a potential therapeutic strategy for patients with arteriosclerotic cSVD, particularly those with low IGF-1 levels.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"7 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849539","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 Blood Pressures Warrant Attention in Modern Clinical Data Infrastructure.","authors":"Steven J Korzeniewski","doi":"10.1161/hypertensionaha.125.24883","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24883","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"3 1","pages":"772-773"},"PeriodicalIF":8.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846381","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":"Placental Endocannabinoid System: Focus on Preeclampsia and Cannabis Use.","authors":"Madhavi S Harhangi,Sinno H P Simons,Hilmar H Bijma,Anna Nguyen,Tuong-Vi Nguyen,Tu'uhevaha Kaitu'u-Lino,Irwin K M Reiss,A H Jan Danser,Michelle Broekhuizen","doi":"10.1161/hypertensionaha.125.24934","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24934","url":null,"abstract":"BACKGROUNDThe endocannabinoid system (ECS) plays an important role in the early stages of pregnancy, while cannabis use during pregnancy associates with a greater risk of preeclampsia. This study quantified the placental ECS component mRNA levels in gestational age-matched healthy pregnant women, women with preeclampsia, and women who used cannabis throughout their pregnancy. Next, it compared the effects of the endogenous ECS agonists anandamide and 2-arachidonoylglycerol with those of the cannabinoid receptor type 1 and 2 agonists HU-210 and HU-308 in chorionic plate arteries.METHODSPlacental mRNA levels were quantified by quantitative polymerase chain reaction. Vascular reactivity was studied with and without selective cannabinoid receptor type 1 and 2 antagonists.RESULTSmRNA levels of 1,2-diacylglycerol lipase α, responsible for 2-arachidonoylglycerol generation, were lowered in preeclampsia, while mRNA levels of the anandamide-synthesizing enzyme N-acyl phosphatidylethanolamine-specific phospholipase D were upregulated in cannabis users. Anandamide-induced relaxation in healthy pregnancy was mediated via cannabinoid receptors type 1 and 2, while 2-arachidonoylglycerol induced relaxation via cannabinoid receptor type 1. In preeclampsia, the effects of anandamide and 2-arachidonoylglycerol were unaltered but no longer involved cannabinoid receptors, while in cannabis users their effects were absent. HU-210 and HU-308 relaxed healthy, but not preeclamptic vessels. The NO donor sodium nitroprusside similarly relaxed healthy and preeclamptic vessels, while its effects in cannabis users were greatly reduced.CONCLUSIONSThe ECS is disturbed in preeclampsia, and endogenous ECS agonists lose their capacity to dilate in cannabis users, while such use also diminishes NO signaling. These data provide mechanistic evidence against cannabis use during pregnancy.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"41 1","pages":"804-815"},"PeriodicalIF":8.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846378","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":"Cardiovascular Disease Risk Awareness and Prevention Perspectives Following Hypertensive Disorders of Pregnancy.","authors":"Nadine Sunji,Natalia Tovar,Kathryn E Flynn,Alisse Hauspurg,Anna Palatnik","doi":"10.1161/hypertensionaha.125.24838","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24838","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"108 1","pages":"e102-e104"},"PeriodicalIF":8.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846380","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":"When Something Does Not Match Up: A Case of Interarm Blood Pressure Discrepancy.","authors":"Thomas J Hanlon,Rebecca DiBlasio,Jennifer Weintraub,Kelsey B Bryant","doi":"10.1161/hypertensionaha.124.23977","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.23977","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"28 1","pages":"765-769"},"PeriodicalIF":8.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846379","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 and Pathophysiology of Preeclampsia: New Mechanistic Insights.","authors":"Gaetano Santulli,Urna Kansakar,Fahimeh Varzideh","doi":"10.1161/hypertensionaha.124.24117","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24117","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"9 1","pages":"800-803"},"PeriodicalIF":8.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846376","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}