Hypertension最新文献_第7页

Implementing the PREVENT Risk Equation in the 2025 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. 实施《2025年成人高血压预防、检测、评估和管理指南》中的Prevention风险方程。

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-14 DOI: 10.1161/hypertensionaha.125.25465

Aletta E Schutte,Louise Pilote

引用次数: 0

Approaching Drug Choices and Challenges for the Management of Hypertension. 高血压治疗的药物选择和挑战。

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-14 DOI: 10.1161/hypertensionaha.125.25462

Adam P Bress,James M Luther

引用次数: 0

Lifetime Cannabis Use and Incident Hypertension: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. 终生使用大麻和高血压事件：年轻人冠状动脉风险发展（CARDIA）研究。

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-11 DOI: 10.1161/hypertensionaha.125.25005

Jamie Corroon,Ryan Bradley,Igor Grant,Michael P Bancks,Julian Jakob,Reto Auer,Jared P Reis,Norrina Allen,Kuan-Hung Yeh,Matthew A Allison

{"title":"Lifetime Cannabis Use and Incident Hypertension: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.","authors":"Jamie Corroon,Ryan Bradley,Igor Grant,Michael P Bancks,Julian Jakob,Reto Auer,Jared P Reis,Norrina Allen,Kuan-Hung Yeh,Matthew A Allison","doi":"10.1161/hypertensionaha.125.25005","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.25005","url":null,"abstract":"BACKGROUNDObservational evidence investigating associations between cannabis use and hypertension is inconsistent.METHODSThe association between cumulative lifetime cannabis use (cannabis-years) and incident hypertension was examined over 35 years in a sample of CARDIA study (Coronary Artery Risk Development in Young Adults) participants free of hypertension at baseline. Marginal structural models with inverse probability weighting were used to adjust for potential time-dependent confounding and censoring. Hazard ratios and 95% CIs were estimated using Cox proportional hazards regression. Sensitivity analyses included modeling cannabis-years using restricted cubic splines, stratifying the primary analyses by sex, race, alcohol and cigarette smoking, and evaluating an additional exposure measure (days of use in the past month).RESULTSThe analytic sample consisted of 4328 participants at baseline and 64.9% (n=2810) at year 35. Median cannabis-years increased minimally and remained low across visits: 0.0 (Q1-Q3, 0.0-0.3) at baseline and 0.2 (Q1-Q3, 0.0-0.7) by year 35. There were 2478 cases of incident hypertension over 88 292 person-years (28.1 cases per 1000 person-years). Cannabis-years were not significantly associated with incident hypertension (adjusted hazard ratio, 0.99 [95% CI, 0.97-1.00]; P=0.18). The association remained unchanged in sensitivity analyses.CONCLUSIONSIn a cohort of Black and White young adults with 35 years of follow-up, no association was found between cumulative lifetime use of cannabis and risk of incident hypertension. This finding was robust to restricted cubic spline analyses, analyses stratified by sex, race, alcohol use and tobacco cigarette smoking, and an additional measure of exposure (days of use in the past month).","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"15 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812869","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}

引用次数: 0

Redefining AT1 Receptor PET Imaging: Introducing the Radiotracer [18F]DR29. 重新定义AT1受体PET成像：引入放射性示踪剂[18F]DR29。

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-08 DOI: 10.1161/hypertensionaha.124.24441

Xinyu Chen,Hiroyuki Kimura,Takanori Sasaki,Konrad Klimek,Saskia Mühlig,Anahi Paula Arias-Loza,Naoko Nose,Yusuke Yagi,Steven P Rowe,Constantin Lapa,Rudolf A Werner,Takahiro Higuchi

{"title":"Redefining AT1 Receptor PET Imaging: Introducing the Radiotracer [18F]DR29.","authors":"Xinyu Chen,Hiroyuki Kimura,Takanori Sasaki,Konrad Klimek,Saskia Mühlig,Anahi Paula Arias-Loza,Naoko Nose,Yusuke Yagi,Steven P Rowe,Constantin Lapa,Rudolf A Werner,Takahiro Higuchi","doi":"10.1161/hypertensionaha.124.24441","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24441","url":null,"abstract":"BACKGROUNDAT1R (angiotensin II type 1 receptors) are central to the renin-angiotensin system and are involved in regulating blood pressure and renal physiology. This study introduces [18F]DR29, a fluorine-18-labeled radiotracer for positron emission tomography imaging, to enable noninvasive visualization of AT1R expression. Its potential applications in understanding AT1R-associated renal processes are explored in healthy and hypertensive rat models.METHODSRadiolabeling was established, and biodistribution studies were conducted on healthy Wistar rats with and without the AT1R antagonist candesartan and transporter inhibitors. Dynamic positron emission tomography imaging assessed tracer specificity, and feasibility for renal AT1R quantification was explored using a hypertensive rat model.RESULTS[18F]DR29 was radiolabeled with a yield of 36±6%. High kidney uptake was observed, significantly reduced by candesartan (kidney-to-blood ratio, 0.43±0.01 versus 4.54±1.59 in vehicle, where vehicle refers to saline without any treatment). Transporter inhibition protocols targeting organic anion transporting polypeptides (liver) and organic anion transporters (kidneys) successfully reduced radiotracer clearance, increasing the specific accumulation of [18F]DR29 in the kidneys and improving renal imaging contrast. Positron emission tomography imaging revealed rapid kidney uptake and stable retention over 2 hours. In hypertensive rats, kidney uptake was higher, aligning with AT1R expression levels.CONCLUSIONSThese results support [18F]DR29 as a promising tool for the noninvasive evaluation of renal AT1R expression in healthy and diseased states. The findings lay the groundwork for clinical translation, offering potential applications in diagnosing and managing kidney-related diseases, including hypertension and other conditions involving AT1R dysregulation.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"68 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796846","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}

引用次数: 0

Lower Prepregnancy Cardiovascular Health is Associated With Hypertensive Disorders of Pregnancy: The CARDIA Study. 低孕前心血管健康与妊娠高血压疾病相关：CARDIA研究

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-08 DOI: 10.1161/hypertensionaha.124.24517

L V Dodds,D J Feaster,C I Kiefe,E P Gunderson,N A Bello,T Rundek,M Paidas,S Kulandavelu,T Elfassy

{"title":"Lower Prepregnancy Cardiovascular Health is Associated With Hypertensive Disorders of Pregnancy: The CARDIA Study.","authors":"L V Dodds,D J Feaster,C I Kiefe,E P Gunderson,N A Bello,T Rundek,M Paidas,S Kulandavelu,T Elfassy","doi":"10.1161/hypertensionaha.124.24517","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24517","url":null,"abstract":"BACKGROUNDHypertensive disorders of pregnancy (HDP), including gestational hypertension, preeclampsia, and eclampsia, contribute to increased maternal morbidity and mortality and long-term cardiovascular disease risk. It is unclear whether HDP arises from pregnancy-specific complications or preexisting maternal cardiovascular traits unmasked during pregnancy. This article evaluates whether cardiovascular health before pregnancy, assessed by the American Heart Association's Life's Essential 8 (LE8) score, is associated with HDP risk.METHODSThe CARDIA (Coronary Artery Risk Development in Young Adults) is a longitudinal cohort study of 5115 Black and White men and women, aged 18 to 30 years at baseline (1985-1986), and followed for over 30 years (nBlackWomen=1480; nWhiteWomen=1307). The LE8 score (range, 0-100) was calculated using health behaviors (diet, smoking, physical activity, sleep) and clinical metrics (body mass index, blood pressure, cholesterol, glucose). Cardiovascular health was categorized as low (LE8 <50), moderate (LE8 50-79), or high (LE8 ≥80). HDP was self-reported as gestational hypertension, preeclampsia, or eclampsia in pregnancies lasting ≥23 weeks. Generalized mixed models assessed the association between LE8 and HDP among 2036 pregnancies from 1227 women, adjusting for age, time-varying parity, education, income, follow-up time, cumulative births, and multiple gestation.RESULTSMean baseline age was 24.1 years, 48.7% were Black women, and 19.9% reported HDP. Women with HDP had lower baseline LE8 scores (77.0 versus 79.5; P<0.01). Compared with high cardiovascular health, moderate (odds ratio, 1.78 [95% CI, 1.13-2.81]) and low cardiovascular health (odds ratio, 3.95 [95% CI, 1.05-14.88]) were associated with increased HDP risk.CONCLUSIONSLower prepregnancy cardiovascular health is an independent risk factor for HDP. Improving cardiovascular health may reduce HDP risk.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"17 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796845","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}

引用次数: 0

Somatic Mutations in MCOLN3 Are Associated With Aldosterone-Producing Adenomas. MCOLN3的体细胞突变与醛固酮分泌腺瘤有关。

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-07 DOI: 10.1161/hypertensionaha.125.24909

Desmaré van Rooyen,Sascha Bandulik,Grace A Coon,Miriam Laukemper,Chandan Kumar-Sinha,Aaron M Udager,Antonio M Lerario,Chaelin Lee,Heather Wachtel,Debbie L Cohen,James M Luther,Thomas J Giordano,Ute I Scholl,Frederike Butz,Bernt Popp,Adina F Turcu,Richard Warth,William E Rainey,Juilee Rege

{"title":"Somatic Mutations in MCOLN3 Are Associated With Aldosterone-Producing Adenomas.","authors":"Desmaré van Rooyen,Sascha Bandulik,Grace A Coon,Miriam Laukemper,Chandan Kumar-Sinha,Aaron M Udager,Antonio M Lerario,Chaelin Lee,Heather Wachtel,Debbie L Cohen,James M Luther,Thomas J Giordano,Ute I Scholl,Frederike Butz,Bernt Popp,Adina F Turcu,Richard Warth,William E Rainey,Juilee Rege","doi":"10.1161/hypertensionaha.125.24909","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24909","url":null,"abstract":"BACKGROUNDPrimary aldosteronism is a common but underdiagnosed cause of endocrine hypertension that contributes to global cardiovascular morbidity and mortality. It is characterized by renin-independent hyperaldosteronism that originates from adrenal lesions-the majority of which are found to harbor aldosterone-driver somatic mutations in genes encoding ion-transporting proteins. These mutations disrupt intracellular calcium homeostasis, facilitating a pathological increase in aldosterone synthase expression and aldosterone production. Elucidating the exact mechanisms causing aldosterone excess in primary aldosteronism would further the development of targeted treatments and alleviate the global hypertension burden.METHODSNext-generation sequencing analysis of formalin-fixed paraffin-embedded aldosterone-producing adenomas identified novel somatic variants in MCOLN3 (encoding the cation-permeable channel, TRPML3). Electrophysiological, fura-2 calcium measurements, gene expression, and steroid quantification studies were performed in adrenal HAC15 cells to characterize the functional effects of the novel MCOLN3 mutations.RESULTSThree somatic MCOLN3 variants (p.Y391D, p.F415I, and p.N411_V412delinsI) were identified in aldosterone-producing adenomas from 4 male primary aldosteronism patients. Mutated MCOLN3 expressed in HAC15 cells resulted in a gain-of-function phenotype, which induced cell membrane depolarization and calcium influx and, in turn, triggered a significant increase in aldosterone synthase expression and aldosterone production.CONCLUSIONSThis is the first report of disease-causing MCOLN3 mutations in humans and the first to implicate mutated MCOLN3 as a driver of dysregulated aldosterone production in primary aldosteronism.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"728 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791987","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}

引用次数: 0

Chronic ACTH Infusion Alters the Diurnal Rhythm of Sodium Excretion, Inducing Nondipping Blood Pressure and Salt-Sensitivity in Male Mice. 慢性ACTH输注改变雄性小鼠钠排泄的昼夜节律，诱导非浸入性血压和盐敏感性。

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-06 DOI: 10.1161/hypertensionaha.124.24473

Hannah M Costello,Céline Grenier,Jessica R Ivy,Alicja Czopek,Natalie K Jones,Georgios Krilis,Kevin Stewart,Josselin Nespoux,Megan C Holmes,Dawn E W Livingstone,Neeraj Dhaun,Matthew A Bailey

{"title":"Chronic ACTH Infusion Alters the Diurnal Rhythm of Sodium Excretion, Inducing Nondipping Blood Pressure and Salt-Sensitivity in Male Mice.","authors":"Hannah M Costello,Céline Grenier,Jessica R Ivy,Alicja Czopek,Natalie K Jones,Georgios Krilis,Kevin Stewart,Josselin Nespoux,Megan C Holmes,Dawn E W Livingstone,Neeraj Dhaun,Matthew A Bailey","doi":"10.1161/hypertensionaha.124.24473","DOIUrl":"https://doi.org/10.1161/hypertensionaha.124.24473","url":null,"abstract":"BACKGROUNDCushing syndrome causes hypertension and increased cardiovascular risk. The hypertensive mechanisms are not clearly defined. We hypothesized that glucocorticoid excess would induce salt-sensitivity, reflecting an impaired pressure-natriuresis response and abnormal salt handling by the kidney.METHODSWe modeled Cushing syndrome in male C57BL/6J mice with prolonged adrenocorticotropic hormone (ACTH) infusion and measured blood pressure on a control diet and following high-salt intake. In a separate group, we assessed renal function and salt excretion, the in vivo pressure-natriuresis response, and ex vivo artery function.RESULTSACTH infusion increased blood pressure, induced nondipping and caused a transition to salt-sensitivity. ACTH infusion reduced the urine sodium/potassium ratio and abolished the diurnal rhythm of sodium excretion. In isolated renal artery, the response to nitric oxide was diminished, and at the mRNA level, we found evidence of arterial remodeling and enhanced TGF-β (transforming growth factor beta) signaling. Autoregulation of renal blood flow was impaired, as was the pressure-natriuresis response.CONCLUSIONSACTH infusion impairs sodium excretion and causes a transition to nondipping and salt-sensitive blood pressure. Renal hemodynamic and tubular abnormalities impair the pressure-natriuresis response. Our findings provide a landscape of the complex physiological response to ACTH excess that may contribute to poor cardiovascular health in Cushing syndrome.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"16 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791988","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}

引用次数: 0

Time-Restricted Feeding Attenuates Salt-Sensitive Hypertension and Renal Damage. 限时喂养减轻盐敏感性高血压和肾损害。

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-06 DOI: 10.1161/hypertensionaha.125.24857

Lauren Yunker,Kristie Usa,Adaysha C Williams,John J Reho,Justin L Grobe,Michelle L Gumz,Alison J Kriegel

{"title":"Time-Restricted Feeding Attenuates Salt-Sensitive Hypertension and Renal Damage.","authors":"Lauren Yunker,Kristie Usa,Adaysha C Williams,John J Reho,Justin L Grobe,Michelle L Gumz,Alison J Kriegel","doi":"10.1161/hypertensionaha.125.24857","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24857","url":null,"abstract":"BACKGROUNDTime-restricted feeding (TRF), a type of intermittent fasting, has been shown to improve blood pressure; however, there is limited data on its effects in salt-sensitive (SS) hypertension. We hypothesized that TRF intervention would attenuate the progression of hypertension and renal damage in Dahl SS rats on a high-salt diet.METHODSChronic 24-hour femoral mean arterial pressure (MAP) was recorded during 1 week of ad libitum low-salt or high-salt feeding, followed by 1 week of ad libitum feeding or TRF (16 hours fasting: 8 hours ad libitum) of the same diet. Cosinor analysis was performed on MAP traces. Comprehensive metabolic phenotyping was performed during the second week of the study. Sodium excretion and creatinine clearance were assessed in 4-hour windows over the final study day.RESULTSRats on high salt developed higher blood pressure during week 1. Implementation of TRF during week 2 blunted further increases in MAP. Reduced MAP during the active phase was responsible for the lower 24-hour MAP in TRF rats. In rats on TRF, the respiratory exchange ratio was reduced during fasting without altering daily sodium intake or body weight. On the final study day, high-salt TRF rats exhibited time-dependent differences in sodium excretion and creatinine clearance.CONCLUSIONSThe TRF regimen attenuated SS hypertension and renal damage in male SS rats on a high-salt diet without altering sodium intake or body weight. If these findings translate clinically, TRF may provide an alternative to a salt-restricted diet for management of SS hypertension.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"17 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144787095","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}

引用次数: 0

Point-of-Care Placental Growth Factor for Predicting Adverse Outcomes in Sierra Leone. 点护理胎盘生长因子预测塞拉利昂不良后果。

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-05 DOI: 10.1161/hypertensionaha.125.24526

Katy Kuhrt,Rossetta Cole,Moses M'Bayoh,Chileshe Mabula-Bwalya,Alice Hurrell,Alexandra Ridout,Cristina Fernandez-Turienzo,Paul T Seed,Lucy C Chappell,Kate Bramham,Andrew H Shennan

{"title":"Point-of-Care Placental Growth Factor for Predicting Adverse Outcomes in Sierra Leone.","authors":"Katy Kuhrt,Rossetta Cole,Moses M'Bayoh,Chileshe Mabula-Bwalya,Alice Hurrell,Alexandra Ridout,Cristina Fernandez-Turienzo,Paul T Seed,Lucy C Chappell,Kate Bramham,Andrew H Shennan","doi":"10.1161/hypertensionaha.125.24526","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24526","url":null,"abstract":"BACKGROUNDPlGF (placental growth factor) concentrations are lower in preeclampsia, a major cause of maternal death; testing improves diagnosis and outcomes. We evaluated 2 novel, whole blood, point-of-care PlGF tests (RONIA and Lepzi Quanti) in a low-resource setting for predicting adverse outcomes.METHODSA prospective observational cohort study in women with hypertension, 24 to 36+6 weeks of gestation, Sierra Leone. Eligible women underwent concealed RONIA and Lepzi Quanti PLGF testing. Optimal rule-out and rule-in thresholds were determined for predicting maternal (death and eclampsia) and perinatal (stillbirth, termination previability, and neonatal death) composite outcomes. Sensitivity, specificity, negative predictive values, and positive predictive values were assessed.RESULTSAnalysis included women with RONIA (n=488) and Lepzi Quanti (n=140) PlGF tests. Optimal thresholds were >60 or >90 pg/mL (rule-out) and <20 or <12 pg/mL (rule-in) for RONIA and Lepzi Quanti, respectively. For tests <34 weeks, RONIA <60 pg/mL had high sensitivity and negative predictive value for ruling out maternal (94.9% and 94.6%) and perinatal (100%) composite outcomes. RONIA <20 pg/mL indicated higher risk (positive predictive values, 16.3% and 40.9% respectively). Lepzi Quanti <90 pg/mL had 100% sensitivity and negative predictive value for ruling out maternal and perinatal composites. Conversely, with Lepzi Quanti <12 pg/mL, nearly one-fourth and half of pregnancies experienced the maternal and perinatal composites (positive predictive values, 22.0% and 48.0%). Performance declined slightly at later gestations.CONCLUSIONSPoint-of-care PlGF testing shows accurate rule-out performance for serious outcomes, with potential for risk stratification in low-resource settings. For both tests, a minority of cases fell into an intermediate category, which would warrant increased surveillance to determine progress.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"15 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778131","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}

引用次数: 0

Is It Time to Abandon the Kidney-Centered View on the Origin of Primary Hypertension? 原发性高血压的起源是时候放弃以肾为中心的观点了吗？

IF 8.3 1区医学

Hypertension Pub Date : 2025-08-05 DOI: 10.1161/hypertensionaha.125.24002

Liffert Vogt,Vitória Cunha,Anna F Dominiczak,Guido Grassi,Marek Rajzer,Agostino Virdis,Thomas Weber

{"title":"Is It Time to Abandon the Kidney-Centered View on the Origin of Primary Hypertension?","authors":"Liffert Vogt,Vitória Cunha,Anna F Dominiczak,Guido Grassi,Marek Rajzer,Agostino Virdis,Thomas Weber","doi":"10.1161/hypertensionaha.125.24002","DOIUrl":"https://doi.org/10.1161/hypertensionaha.125.24002","url":null,"abstract":"Traditionally, the kidney has been thought to play a key role in the development of hypertension. Disturbed sodium regulatory pathways can lead to primary hypertension, with abnormalities in the pressure-natriuresis mechanism contributing to its onset. An adverse intrauterine environment and postnatal stressors can affect nephron number, further linking renal development to hypertension risk. The development of hypertension may, however, also be influenced by alternative factors beyond the kidney. Monogenic diseases and polygenic risk scores are associated with hypertension development. Epigenetic mechanisms can influence the phenotype of the vascular endothelium in response to environmental stimuli, potentially leading to changes in blood pressure. Regulation of vascular tone, microvascular rarefaction, and interactions with the immune system are other nonrenal factors contributing to hypertension. The exposome, including air pollution and noise, has its impact already before conception via maternal and paternal influences, as well as later in life. In addition, lifestyle factors such as sodium and alcohol intake and tobacco use have been linked to hypertension through mechanisms such as increased sympathetic activity and vasoconstriction, highlighting the importance of behavioral factors in hypertension development. Age-related stiffening becomes important in later life, influences blood pressure phenotype, and may even precede hypertension development. Considering these multiple contributors, relevant for pathophysiology, prevention, and management of hypertension, the question arises whether the kidney-centered view on hypertension is sufficient or whether a more integrative, multifactorial perspective is needed. Full understanding of renal and nonrenal factors and their interactions driving hypertension is crucial to curb the global burden of this disease.","PeriodicalId":13042,"journal":{"name":"Hypertension","volume":"29 1","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778130","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}

引用次数: 0