Hypertension最新文献

{"title":"Correction to: Antihypertensive Medication Regimens Used in the Systolic Blood Pressure Intervention Trial.","authors":"","doi":"10.1161/HYP.0000000000000241","DOIUrl":"https://doi.org/10.1161/HYP.0000000000000241","url":null,"abstract":"","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"81 12","pages":"e203"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681737","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":"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}

{"title":"Water and Electrolyte Content in Hypertension in the Skin (WHYSKI) in Primary Aldosteronism.","authors":"Francesca Torresan, Federico B Rossi, Ilaria Caputo, Sofia Zanin, Brasilina Caroccia, Andrea Mattarei, Michela Paccagnella, Eva Kohlscheen, Teresa M Seccia, Maurizio Iacobone, Gian-Paolo Rossi","doi":"10.1161/HYPERTENSIONAHA.124.23700","DOIUrl":"10.1161/HYPERTENSIONAHA.124.23700","url":null,"abstract":"<p><strong>Background: </strong>Primary aldosteronism (PA), the most common curable salt-dependent form of arterial hypertension, features renal K⁺ loss and enhanced Na⁺ reabsorption. We investigated whether the electrolyte, water, and TonEBP (tonicity-responsive enhancer binding protein)/<i>NFAT5</i> (nuclear factor of activated T cells 5) content is altered in the skin of patients with PA and corrected by surgical cure.</p><p><strong>Methods: </strong>We obtained skin biopsies from 80 subjects: 49 consecutive patients with PA, optimally treated with a mineralocorticoid receptor antagonist; 6 essential hypertensives; and 25 normotensive controls. We measured Na⁺, K⁺, water content with atomic absorption spectroscopy after ashing, and <i>NFAT5</i> mRNA with digital droplet polymerase chain reaction. The patients with PA were retested after adrenalectomy.</p><p><strong>Results: </strong>We discovered a higher dry weight of the skin biopsy specimen at surgery than at follow-up (<i>P</i><0.001) and a direct correlation with electrolyte and water content (all <i>P</i><0.01), indicating the need for dry weight adjustment of electrolyte and water data. Surgical cure of PA markedly increased skin dry weight-adjusted K⁺ (from 1.14±0.1 to 2.81±0.27 µg/mg; <i>P</i><0.001) and water content (from 2.92±1.4 to 3.85±0.23 mg/mg; <i>P</i><0.001), but left dry weight-adjusted skin Na⁺ content unaffected. In patients with PA at baseline, <i>NFAT5</i> mRNA was higher (<i>P</i>=0.031) than in normotensive controls and decreased after surgery (<i>P</i>=0.035).</p><p><strong>Conclusions: </strong>Despite mineralocorticoid receptor antagonist treatment ensuring normokalemia, the patients with PA had a skin cell K⁺ depletion that was corrected by adrenalectomy. The activated <i>NFAT5</i>/TonEBP pathway during mineralocorticoid receptor antagonist administration suggests enhanced skin Na⁺ lymphatic drainage and can explain the lack of overt skin Na⁺ accumulation in patients with PA. Its deactivation after surgical cure can account for the lack of skin Na⁺ decrease postadrenalectomy.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT06090617.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"2468-2478"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361455","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":"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}

{"title":"Caregiving and Hypertension in Younger Black Women: The Jackson Heart Study.","authors":"Milla Arabadjian, Yiwei Li, Byron Jaeger, Calvin L Colvin, Jolaade Kalinowski, Miriam A Miles, Lenette M Jones, Jacquelyn Y Taylor, Kenneth Butler, Paul Muntner, Tanya M Spruill","doi":"10.1161/HYPERTENSIONAHA.124.23721","DOIUrl":"https://doi.org/10.1161/HYPERTENSIONAHA.124.23721","url":null,"abstract":"<p><strong>Background: </strong>Caregiving has been associated with high blood pressure in middle-aged and older women, but this relationship is understudied among younger Black women, a population at high risk for hypertension. We examined the associations of caregiving stress and caregiving for high-needs dependents with incident hypertension among reproductive-age women in the JHS (Jackson Heart Study), a cohort of community-dwelling Black adults.</p><p><strong>Methods: </strong>We included 453 participants, aged 21 to 44 years, with blood pressure <140/90 mm Hg, and not taking antihypertensive medication at baseline (2000-2004). Caregiving stress over the past 12 months was assessed via a single item in the global perceived stress scale. Caregiving for a high-needs dependent status was assessed via a question on hours per week spent caregiving for children (≤5 years or disabled) or older adults. Incident hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or self-report of taking antihypertensive medication at follow-up exams in 2005 to 2008 and 2009 to 2013.</p><p><strong>Results: </strong>Over a median follow-up of 7.4 years, 43.5% of participants developed hypertension. Participants with moderate/high versus no/low caregiving stress had a higher incidence of hypertension (51.7% versus 40.6%). Higher caregiving stress was associated with incident hypertension after adjustment for sociodemographic and clinical factors, health behaviors, and depressive symptoms (hazard ratio, 1.39 [95% CI, 1.01-1.94]). Being a caregiver for a high-needs dependent was not associated with incident hypertension (adjusted hazard ratio, 0.88 [95% CI, 0.64-1.21]).</p><p><strong>Conclusions: </strong>Higher caregiving stress among reproductive-age Black women was associated with incident hypertension. Hypertension prevention approaches for this high-risk population may include caregiving stress management strategies.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728107","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":"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^2.7.</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}

{"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}

{"title":"Global Blood Pressure Screening During and After Pregnancy: May Measurement Month 2019.","authors":"Liza Bowen, Richard J Stevens, Aletta E Schutte, Thomas Beaney, Neil R Poulter, Richard J McManus, Lucy C Chappell","doi":"10.1161/HYPERTENSIONAHA.124.23458","DOIUrl":"10.1161/HYPERTENSIONAHA.124.23458","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorders of pregnancy are associated with high maternal and fetal morbidity and mortality. There are limited global data on the characteristics of women during and after pregnancy hypertension.</p><p><strong>Methods: </strong>May Measurement Month is a global campaign to raise awareness of the importance of blood pressure. Adults (≥18 years) recruited through opportunistic sampling during May 2019 had blood pressure measured and comorbidities and lifestyle data collected. This secondary analysis included 16 519 pregnant women and 529 172 nonpregnant women (16 457 with previous raised blood pressure in pregnancy) from 64 countries.</p><p><strong>Results: </strong>Almost half of the pregnant women (43.3%) reported not having had their blood pressure measured in the past year, and 14.3% (95% CI, 12.1-16.6) had hypertension (blood pressure ≥140/90 mm Hg or taking antihypertensive medication). Diabetes was self-reported in 7.6% (5.9-9.3) of pregnant women with hypertension and 2.8% (1.9-3.6) of pregnant women without hypertension. In nonpregnant women with and without a history of pregnancy hypertension, age-standardized proportions with current hypertension were 53.2% (50.8-55.7) versus 33.3% (29.3-37.3); with diabetes were 14.4% (11.8-17.0) versus 8.5% (6.3-10.9); and with body mass index ≥30 kg/m² were 28.4% (23.5-33.3) versus 16.6% (13.0-20.2).</p><p><strong>Conclusions: </strong>Hypertension in pregnancy was common in this global sample but many cases had not previously been identified. There was a clustering of cardiovascular risk factors in both pregnant women with current hypertension and previously raised blood pressure in pregnancy. This work highlights the importance of screening pregnant women for hypertension, which remains a challenge in large parts of the world.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"2298-2306"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153883","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":"Angiotensin in the Arcuate: Mechanisms Integrating Cardiometabolic Control: The 2022 COH Mid-Career Award for Research Excellence.","authors":"Samuel B R Lawton, Valerie A Wagner, Pablo Nakagawa, Jeffrey L Segar, Curt D Sigmund, Lisa L Morselli, Justin L Grobe","doi":"10.1161/HYPERTENSIONAHA.124.20524","DOIUrl":"10.1161/HYPERTENSIONAHA.124.20524","url":null,"abstract":"<p><p>The American Heart Association has identified obesity as a primary impediment to ongoing improvements in cardiovascular diseases, including hypertension. Although drugs, exercise, diets, and surgeries can each cause weight loss, few subjects maintain a reduced weight over the long term. Dysfunctional integrative control (ie, adaptation) of resting metabolic rate (RMR) appears to underlie this failed weight maintenance, yet the neurobiology of physiological and pathophysiological RMR control is poorly understood. Here, we review recent insights into the cellular and molecular control of RMR by Ang-II (angiotensin II) signaling within the arcuate nucleus of the hypothalamus. Within a unique subset of agouti-related peptide neurons, AT₁R (Ang-II type 1 receptors) are implicated in the integrative control of RMR. Furthermore, a spontaneous G protein signal switch of AT₁R within this neuron type appears to underlie the pathogenesis of RMR adaptation by qualitatively changing the cellular response to AT₁R activation from a β-arrestin-1/Gαi (heterotrimeric G protein, α i subtype)-mediated inhibitory response to a Gαq (heterotrimeric G protein, α q subtype)-mediated stimulatory response. We conclude that therapeutic approaches to obesity are likely hampered by the plasticity of the signaling mechanisms that mediate the normal integrative control of energy balance. The same stimulus that would increase RMR in the normal physiological state may decrease RMR during obesity due to qualitative changes in second-messenger coupling. Understanding the mechanisms that regulate interactions between receptors such as AT₁R and its various second messenger signaling cascades will provide novel insights into the pathogenesis of RMR adaptation and potentially point toward new therapeutic approaches for obesity and hypertension.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"2209-2217"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307653","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":"Prevalence of Hyperkalemia and Familial Hyperkalemic Hypertension in 5100 Patients Referred to a Tertiary Hypertension Unit.","authors":"Martina Tetti, Jacopo Burrello, Marguerite Hureaux, Clarisse Billon, Eric Clauser, Franco Veglio, Franco Rabbia, Barbara Pasini, Annalisa Crisetti, Xavier Jeunemaitre, Paolo Mulatero, Silvia Monticone","doi":"10.1161/HYPERTENSIONAHA.124.23500","DOIUrl":"10.1161/HYPERTENSIONAHA.124.23500","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalemia is a frequent electrolyte alteration whose prevalence varies widely, depending on the adopted cutoff, the setting (inpatients versus outpatients), and the characteristics of the study population. Familial hyperkalemic hypertension (FHH) is a rare cause of hypertension, hyperkalemia, and hyperchloremic metabolic acidosis.</p><p><strong>Methods: </strong>In this retrospective observational study, we investigated the prevalence of hyperkalemia (serum K⁺ >5.2 mmol/L on 2 repeated measurements) in 5100 referred patients affected by arterial hypertension, the potential causes, and the associated cardiovascular risk profile.</p><p><strong>Results: </strong>Overall, 374 (7.3%) patients had hyperkalemia. This was associated with drugs known to increase K⁺ levels (74.6%), chronic kidney disease (33.7%), or both (24.3%). Among the 60 patients with unexplained hyperkalemia, 3 displayed a clinical and biochemical phenotype suggestive of FHH that was genetically confirmed in 2 of them (0.04% in the entire cohort). FHH prevalence rose to 3.3% in patients with unexplained hyperkalemia and up to 29% (2/7) if they had serum K⁺>5.8 mmol/L. The genetic cause of FHH was a missense variant affecting the acidic motif of <i>WNK1</i> in 1 family and a rare <i>CUL3</i> splicing variant, whose functional significance was confirmed by a minigene assay, in another. Finally, we observed a significant association between hyperkalemia and the occurrence of cardiovascular events, metabolic syndrome, and organ damage, independent of potential confounding factors.</p><p><strong>Conclusions: </strong>The identification of hyperkalemia in patients with hypertension has prognostic implications. A timely diagnosis of FHH is important for effective management of hypertension, electrolyte imbalance correction with tailored treatment, and genetic counseling.</p>","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":" ","pages":"2275-2285"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125577","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}