George S Stergiou, Ariadni Menti, Roland Asmar, Grzegorz Bilo, Angeliki Ntineri, Paolo Palatini, Gianfranco Parati, Andrew Shennan, Ji-Guang Wang, Alejandro De La Sierra, Anastasios Kollias, Aletta E Schutte
{"title":"Updated practical guide for validation studies of automated cuff blood pressure monitors according to the Universal Standard by the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (ISO 81060-2:2018) and Amendments 1:2020 and 2:2024.","authors":"George S Stergiou, Ariadni Menti, Roland Asmar, Grzegorz Bilo, Angeliki Ntineri, Paolo Palatini, Gianfranco Parati, Andrew Shennan, Ji-Guang Wang, Alejandro De La Sierra, Anastasios Kollias, Aletta E Schutte","doi":"10.1097/HJH.0000000000004448","DOIUrl":"10.1097/HJH.0000000000004448","url":null,"abstract":"<p><p>Validated blood pressure (BP) monitors are essential for the accurate diagnosis and management of hypertension. In 2018, the Association for the Advancement of Medical Instrumentation (AAMI), the European Society of Hypertension (ESH), and the International Organization for Standardization (ISO) introduced the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) to establish globally accepted requirements for validation studies. This standard is developed specifically for cuff BP devices and is inadequate for cuffless ones, which require different validation procedures. In 2018, the ESH Working Group on Blood Pressure Monitoring published a practical guide and checklist for performing and reporting validation studies of cuff BP devices. Thereafter, two recent amendments (1:2020 and 2:2024) introduced additional requirements for limb and cuff size distribution to ensure that the entire limb range per cuff is adequately assessed. Despite these major initiatives, regular reviews of published validation studies performed by STRIDE BP have identified persistent violations of the validation requirements and incomplete reporting of important data. This statement, prepared by STRIDE BP and the ESH Working Group on Blood Pressure Monitoring, provides an updated guide and checklists, which are complementary to our 2019 guide and aim at assisting investigators and reviewers in performing and reporting high-quality validation studies of cuff BP devices that comply with the latest requirements by the AAMI/ESH/ISO Universal Standard.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giuseppe Mancia, Rita Facchetti, Cesare Cuspidi, Giovanni Corrao, Guido Grassi
{"title":"Twenty-four-hour mean blood pressure and variability combined improve the prognostic value of ambulatory blood pressure.","authors":"Giuseppe Mancia, Rita Facchetti, Cesare Cuspidi, Giovanni Corrao, Guido Grassi","doi":"10.1097/HJH.0000000000004413","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004413","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether adding 24-h blood pressure (BP) variability to 24-h mean BP improves the BP predictive value for cardiovascular and all-cause fatal outcomes.</p><p><strong>Methods: </strong>In 1993, among individuals of the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) population, 24-h mean BP was calculated from the mean of three hourly measurements. BP variability was quantified as the weighted standard deviation of the 24-h mean BP, the 24-h average real variability and the 24-h erratic BP variations by Fourier analysis. Variability values were used after removal of the fraction explained by their linear relationship with 24-h mean BP. Data were adjusted for baseline covariates but because of within-subject comparisons unadjusted data were also used.</p><p><strong>Results: </strong>During a 24.6 years follow-up, 250 cardiovascular and 798 all-cause deaths occurred. Adding any of the BP variability measures to 24-h mean BP significantly improved the goodness of fit of the data to the Cox prediction model used to estimate cardiovascular risk and all-cause mortality. This occurred also when BP variability was added to the net reclassification improvement (NRI) index. In subgroup analysis, a significant increase in the risk of cardiovascular and all-cause mortality was consistent in subjects with both 24-h mean and variability at least at their median value.</p><p><strong>Conclusion: </strong>Addition of 24-h BP variability improves the prognostic estimate of the risk of cardiovascular and all-cause mortality associated with 24-h mean BP. This supports an upgrading of information on BP variability in ambulatory BP monitoring reports to better exploit the potential of this approach as risk estimate.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrative genomic and functional analysis identifies BCL10 as a novel driver of trophoblast senescence in preeclampsia.","authors":"Dandan Xia, Yuhui Zhang, Siyu Li, Wenjie Liu, Chenying Zhang, Guangtong She, Huiyan Wang","doi":"10.1097/HJH.0000000000004474","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004474","url":null,"abstract":"<p><strong>Objective: </strong>To identify senescence-driving genes causally linked to preeclampsia (PE) and to elucidate impact on placental dysfunction.</p><p><strong>Methods: </strong>Placental RNA-seq data set GSE234729 was analyzed for differentially expressed genes. Weighted gene co-expression network analysis was used to extract aging-related genes (ARGEs) in PE. Mendelian randomization (MR) with eQTLs from GTEx prioritized candidate genes. In vitro validation employed HTR-8/SVneo cells exposed to 100 μM H2O2 as a senescence model, and functional verification was conducted through BCL10 overexpression or silencing. Senescence was quantified by SA-β-gal staining and aging-related proteins, invasion by Transwell assays, migration by Scratch assays. BCL10-silenced cells underwent transcriptome analysis.</p><p><strong>Results: </strong>Integrating GSE234729 dataset, we identified 1488 differentially expressed genes and 1649 WGCNA hub genes, yielding 39 aging-related genes. MR pinpointed BCL10 as a risk factor for PE. PE placental tissues of patients and H2O2-treated HTR-8/SVneo cells showed significantly trophoblast senescence. BCL10 was significantly upregulated in PE, accompanied by the upregulation of senescence markers P62 and MMP3, and associated with body mass index (BMI) at delivery. Functionally, BCL10 overexpression increased P53/P21/P16, decreased Lamin B1, enhanced SA-β-gal activity, and inhibited invasion, while siRNA-mediated knockdown reversed these changes. BCL10 silencing in HTR-8/SVneo cells alters expression of 722 genes enriched in immune-inflammatory responses, apoptosis, and pathways including NF-κB and NOD-like receptor signaling.</p><p><strong>Conclusions: </strong>BCL10 emerges as a causal, pro-senescence factor in PE that impairs trophoblast dysfunction. Targeting BCL10 may offer a novel strategy to alleviate placental aging-related complications in PE.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 aortic pulse wave velocity in healthy Chinese adults: a national multicenter prospective study.","authors":"Zhen Wang, Yong Yang, Kun Wang, Xiaofeng Sun, Yuqiong Lai, Xinxiu Liu, Jie Gao, Xiaohong Xu, Aijun Liu, Huimin Li, Shuang Liu, Fenglin Dong, Li Chen, Chunling Zhang, Qing Jin, Yong Liu, Liping Liu, Yiping Jia, Xiaohui Liu, Yi Hao, Lin Jin, Mingjie Gao, Xinqiao Tian, Jinzhuo Yue, Shiping Wu, Jiaqi Zhao, Yong Yang, Lijun Yuan","doi":"10.1097/HJH.0000000000004467","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004467","url":null,"abstract":"<p><strong>Objective: </strong>The use of carotid-femoral pulse wave velocity (cfPWV), a reliable indicator of aortic stiffness and a powerful predictor of cardiovascular disease, has remained limited in routine clinical practice in China, due to the lack of standardized reference values. This national multicenter study aimed to establish the reference values for cfPWV in healthy Chinese adult population.</p><p><strong>Methods: </strong>Participants were prospectively recruited across 29 participating centers in China and were categorized by age decade and blood pressure (BP) categories. A consistent ultrasound semi-automatic technique along with standardized measuring protocols was applied across all centers and participants to measure cfPWV. The carotid-femoral transit distance was determined using 0.8× direct carotid-femoral tape measure distance, and the cfPWV was calculated as transit distance/transit time.</p><p><strong>Results: </strong>The study included 3328 adult participants (1431 men, 43%), age 45.7 ± 14.4 years. The distribution of cfPWV values with age and BP categories were described, and reference values were established. The 5th and 95th percentile values for cfPWV were: 18-29 years: 4.27, 7.57 m/s; 30-39 years: 4.65, 8.45 m/s; 40-49 years: 5.14, 9.49 m/s; 50-59 years: 5.34, 10.82 m/s; 60-69 years: 5.52, 12.04 m/s; and at least 70 years: 6.05, 14.69 m/s, respectively. Age, mean arterial pressure, heart rate, sex, low-density lipoprotein cholesterol level and family history of cardiovascular disease were independently correlated with cfPWV (P < 0.05).</p><p><strong>Conclusion: </strong>Based on a large cohort of Chinese population, this study has established the reference values for cfPWV. Given the profound cardiovascular implications and powerful predictive value of cfPWV, the findings of this study represent a critical step forward in facilitating the wider integration of aortic stiffness assessment into routine clinical practice in China.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vasileios Thymis, Konstantinos G Kyriakoulis, Ariadni Menti, Aikaterini Theodosiadi, Rigas Kalaitzidis, Panagiotis I Georgianos, Maria-Iosifina Kasdagli, Anastasios Kollias, Vasiliki Benetou, George S Stergiou
{"title":"Hypertension phenotypes in nondialysis patients with chronic kidney disease: systematic review and meta-analysis.","authors":"Vasileios Thymis, Konstantinos G Kyriakoulis, Ariadni Menti, Aikaterini Theodosiadi, Rigas Kalaitzidis, Panagiotis I Georgianos, Maria-Iosifina Kasdagli, Anastasios Kollias, Vasiliki Benetou, George S Stergiou","doi":"10.1097/HJH.0000000000004441","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004441","url":null,"abstract":"<p><p>In nondialysis chronic kidney disease (CKD) patients, masked hypertension (MH), white-coat hypertension (WCH), nondipping, and nocturnal hypertension phenotypes are known to complicate the diagnostic and therapeutic approach, but their prevalence remains unclear. A systematic search of two databases (PubMed, EmBase) from inception through October 1, 2025 was performed to identify records reporting MH, WCH, nocturnal hypertension, and nondipping prevalence in this population. A meta-analysis (REML model) was conducted to calculate respective pooled prevalences. From 2355 records screened, 68 were selected including 41 989 patients. Meta-analysis of 33 studies (n = 26 539, weighted mean age 60.9 years, 58% males, mean eGFR 49.3 ml/min) indicated 11% pooled WCH prevalence [95% confidence interval (CI) (8, 14%)]. Further analyses (33 studies, n = 26 542) indicated pooled MH prevalence 23% (19, 27%), pooled nondipping and dipping prevalence 66% (61, 70%) and 34% (30, 39%), respectively (49 studies, n = 22 773 - two phenotype analysis) and pooled dipping, nondipping, extreme dipping and reverse dipping pooled prevalence 28% (24, 33%), 43% (40, 46%), 3% (2, 6%), 23% (18, 27%) respectively (20 studies, n = 10 865 - four phenotype analysis). Meta-analysis of 14 studies (n = 15 701) indicated nocturnal hypertension prevalence 57% (47, 67%). Ambulatory and home blood pressure monitoring were equivalent in detecting WCH and MH (P = 0.68/0.4, respectively). Glomerular filtration rate was not associated with the MH/WCH prevalence. Nondialysis CKD patients experience an important burden of MH, nocturnal hypertension and nondipping, and lesser WCH. These results strongly support the necessity for out-of-office blood pressure evaluation in these patients.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dewald Naudé, Wayne Smith, Roland von Känel, Annemarie Wentzel
{"title":"Acute mental stress-induced adrenergic reactivity profiles predict distinct cardiometabolic risk trajectories over three years: the SABPA study.","authors":"Dewald Naudé, Wayne Smith, Roland von Känel, Annemarie Wentzel","doi":"10.1097/HJH.0000000000004454","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004454","url":null,"abstract":"<p><strong>Objectives: </strong>We previously characterised acute mental stress-induced alpha (α)- and beta (β)-adrenergic-haemodynamic reactivity profiles cross-sectionally and related them to unique cardiometabolic risk outcomes. Whether these profiles predict future cardiometabolic risk remains unclear. We compared three-year cardiometabolic risk outcomes between predominant α- and β-responders and evaluated the prognostic value of each profile for predicting cardiometabolic risk.</p><p><strong>Methods: </strong>Participants (aged 20-65 years) were stratified at baseline as predominant α- (n = 43) or β-responders (n = 59) defined by lowest and highest population quartiles, respectively, of reactivity in both cardiac output and Windkessel arterial compliance. Remaining participants were classified as mixed-α/β-responders (n = 227). Hypertension and central obesity at baseline and follow-up were defined using international guidelines. Other outcomes included cardiac stress (cardiac troponin-T ≥4.2 pg/ml), abnormal-glucose-tolerance (Abnl-GT; HbA1c ≥5.7% and/or fasting glucose ≥5.6 mmol/l and/or using antidiabetic medication), 10-year atherosclerotic cardiovascular disease (ASCVD)-risk (UCLA composite score), 24-h ischaemic events (Holter-electrocardiography) and an adverse lipid profile (high total cholesterol, low high-density-lipoprotein (HDL)-cholesterol and high triglycerides) defined by South African Heart Association/Lipid and Atherosclerosis Society of Southern Africa guidelines. Three-year risk for each outcome by adrenergic profile were estimated using covariate-adjusted Cox-proportional hazard models.</p><p><strong>Results: </strong>At three-year follow-up, α-responders had higher prevalence of hypertension, Abnl-GT, low HDL-cholesterol, and 10-year ASCVD-risk than β-responders (all P ≤ 0.025). Both α- and β-adrenergic reactivity profiles were associated with increased three-year risk of 10-year ASCVD, cardiac stress, central obesity, and Abnl-GT (all P ≤ 0.047). The α-adrenergic reactivity profile uniquely predicted elevated risk of hypertension, high total cholesterol, and low HDL-cholesterol (all P ≤ 0.009), whereas the β-adrenergic reactivity profile was associated with lower risk of hypertension and high total cholesterol but higher risk of 24-h ischaemic events (all P ≤ 0.016).</p><p><strong>Conclusion: </strong>Acute mental stress-induced α- and β-adrenergic reactivity profiles independently predicted distinct cardiometabolic outcomes over three-years, delineating differential pathways of cardiometabolic risk. These findings support the potential utility of adrenergic reactivity phenotypes to refine individual, psychophysiological-linked cardiometabolic risk stratification.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Artemios G Karagiannidis, Fotini Iatridi, Marieta P Theodorakopoulou, Eleni Karkamani, Sofia Manti, Areti Georgiou, Amalia Baroutidou, Spyros Gerou, Zoi Athanasiadou, Christodoulos Papadopoulos, Pantelis Sarafidis
{"title":"Nighttime and daytime urine sodium excretion, nighttime and daytime blood pressure and nocturia frequency in patients with chronic kidney disease.","authors":"Artemios G Karagiannidis, Fotini Iatridi, Marieta P Theodorakopoulou, Eleni Karkamani, Sofia Manti, Areti Georgiou, Amalia Baroutidou, Spyros Gerou, Zoi Athanasiadou, Christodoulos Papadopoulos, Pantelis Sarafidis","doi":"10.1097/HJH.0000000000004453","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004453","url":null,"abstract":"<p><strong>Objective: </strong>Abnormal circadian blood pressure (BP) regulation is common in chronic kidney disease (CKD) and associated with adverse cardiovascular outcomes. In hypertensive individuals, higher nighttime natriuresis is linked to elevated nighttime BP, but evidence in CKD is limited. We hypothesized that impaired circadian renal sodium handling, characterized by increased nighttime natriuresis, would also be associated with higher nighttime BP and adverse nocturnal BP phenotypes. The primary aim was to examine differences in daytime and nighttime BP, dipping and nocturia frequency between CKD patients classified by nighttime-to-daytime urine sodium excretion ratio; secondary aim was to compare diurnal sodium excretion and nocturia between CKD patients with and without nocturnal hypertension.</p><p><strong>Methods: </strong>One hundred and thirty patients with CKD stages 1-5 on stable antihypertensive treatment underwent 24-h ambulatory BP monitoring (ABPM) with the ABPMpro device and simultaneous split 24-h urine collection separated into daytime (7 : 00-23 : 00) and nighttime (23 : 00-7 : 00) periods. For analyses, patients were divided by tertiles of nighttime-to-daytime ratio of urine sodium excretion and by presence of nocturnal hypertension.</p><p><strong>Results: </strong>No significant differences were detected in baseline characteristics across groups of nighttime-to-daytime sodium excretion ratio. In contrast to daytime SBP/DBP (T1: 124.8 ± 10.1/70.6 ± 7.9 vs. T2: 128.3 ± 12.2/74.6 ± 8.6 vs. T3: 128.6 ± 12.8/73.6 ± 8.2 mmHg, P = 0.254/P = 0.072 respectively), nighttime SBP and DBP (117.1 ± 12.0/64.8 ± 6.9 vs. 121.7 ± 13.1/68.7 ± 7.6 vs. 123.8 ± 13.1/69.3 ± 8.1 mmHg, P = 0.047/P = 0.014, respectively) showed significant increases across tertiles of nighttime-to-daytime sodium excretion. When patients with and without nocturnal hypertension were compared, those with nocturnal hypertension had similar daytime (83.8 ± 45.9 vs. 87.6 ± 50.6 mEq, P = 0.654), but higher nighttime urine sodium excretion (64.0 ± 34.5 vs. 49.7 ± 23.9 mEq, P = 0.012), higher nighttime-to-daytime sodium excretion ratio (0.73 [0.53] vs. 0.57 [0.63], P = 0.037) and more frequent nocturia (2 [2] vs. 1 [2.0], P = 0.006). Nighttime sodium excretion correlated with nighttime SBP (r = 0.212, P = 0.016) and DBP (r = 0.320, P < 0.001), while daytime sodium excretion did not.</p><p><strong>Conclusion: </strong>In CKD, impaired circadian renal sodium handling, characterized by increased nighttime natriuresis, is linked to higher nighttime BP and nocturnal hypertension. Assessment of nighttime urine sodium excretion may help identify sodium-related nocturnal hypertension and guide targeted therapeutic strategies.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicolò De Biase, Lavinia Del Punta, Sara Moura-Ferreira, Stephanie De Schutter, Antonio Iaconelli, Valerio Di Fiore, Stefano Taddei, Andreas B Gevaert, Jan Verwerft, Nicola R Pugliese, Stefano Masi
{"title":"Disproportionate systolic blood pressure response relative to oxygen consumption identifies a high-risk haemodynamic phenotype in arterial hypertension.","authors":"Nicolò De Biase, Lavinia Del Punta, Sara Moura-Ferreira, Stephanie De Schutter, Antonio Iaconelli, Valerio Di Fiore, Stefano Taddei, Andreas B Gevaert, Jan Verwerft, Nicola R Pugliese, Stefano Masi","doi":"10.1097/HJH.0000000000004438","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004438","url":null,"abstract":"<p><strong>Objectives: </strong>Conventional definitions of hypertensive response to exercise (HRE) rely on absolute systolic blood pressure (SBP) thresholds, which do not account for the metabolic demand driving the pressor response and show inconsistent association with pathophysiology and prognosis. Whether indexing SBP to oxygen consumption (VO2) provides independent pathophysiological information along the continuum from arterial hypertension (AH) to heart failure (HF) remains unclear. We investigated the haemodynamic and prognostic implications of the SBP/VO2 slope in patients with AH and preserved left ventricular ejection fraction.</p><p><strong>Methods: </strong>We enrolled 970 participants with AH, including 34% with established HF. All subjects underwent baseline echocardiography and cardiopulmonary exercise testing with stress echocardiography. We categorized patients into tertiles of the slope of SBP relative to peak VO2 from rest to peak exercise; the highest tertile was used to define HRE for descriptive analyses. Patients were followed for all-cause mortality or HF-related hospitalisation.</p><p><strong>Results: </strong>Patients with HRE (SBP/VO2 slope >5.7 mmHg/ml/kg/min) displayed adverse cardiac remodelling (higher left ventricular mass index, left atrium dilation), systemic exercise-induced vascular dysfunction (elevated peak systemic vascular resistance, reduced total arterial compliance), and reduced peripheral oxygen extraction (lower peak arteriovenous oxygen difference), despite well controlled resting BP. Over a 24-month median follow-up, a steeper SBP/VO2 slope was associated with a higher risk of death or HF-related hospitalisation, independent of peak VO2 (hazard ratio per 1-standard deviation increase: 1.21; P = 0.041).</p><p><strong>Conclusions: </strong>In patients with AH, a steeper SBP/VO2 slope identifies a high-risk haemodynamic phenotype and may represent an early marker of progression along the continuum from AH to HF.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Óscar Martínez-Cifuentes, Peter M Nilsson, Alicia Saz-Lara, Sara Valladolid-Ayllón, Alba María Hitado-Cifuentes, Irene Martínez-García, Iván Cavero-Redondo
{"title":"Age-specific reference values for pulse wave velocity in paediatric populations: a systematic review with meta-analysis.","authors":"Óscar Martínez-Cifuentes, Peter M Nilsson, Alicia Saz-Lara, Sara Valladolid-Ayllón, Alba María Hitado-Cifuentes, Irene Martínez-García, Iván Cavero-Redondo","doi":"10.1097/HJH.0000000000004468","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004468","url":null,"abstract":"<p><strong>Background/objectives: </strong>Arterial stiffness, assessed by pulse wave velocity (PWV), is a key marker of vascular aging and an independent predictor of cardiovascular morbidity and mortality. Age is the primary determinant of PWV; however, age-specific and sex-specific reference values in healthy paediatric populations are not yet well defined. Therefore, this study aimed to establish reference values for PWV in healthy children.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of observational studies reporting age-stratified PWV values in healthy children was conducted. Pooled mean estimates and 95% confidence intervals (95% CIs) were calculated using random effects models. Additional sex-stratified analyses were performed, and percentile distributions were examined to enhance clinical applicability.</p><p><strong>Results: </strong>Ten studies were included in the quantitative synthesis. A nonlinear pattern was observed: PWV was greater in the 0-5-year age group (5.33 m/s) than in the 6-8-year age group (4.93 m/s), followed by a progressive increase up to 15-18 years (5.80 m/s). This trend was consistent across sexes. Substantial heterogeneity between studies was detected, and Egger's test suggested the presence of publication bias across several age groups, both in sex-stratified analyses and in the overall population.</p><p><strong>Conclusion: </strong>Age is the primary determinant of arterial stiffness during childhood and is influenced by physiological processes such as arterial wall maturation early in life and puberty. Establishing age-specific reference values for PWV provides an essential clinical tool for the early detection of accelerated vascular aging and cardiovascular risk stratification from early stages of life.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alveolar macrophage heterogeneity in pulmonary hypertension: pathogenic mechanisms and precision intervention.","authors":"Tianfei Fan, Yao Wang, Longji Li","doi":"10.1097/HJH.0000000000004458","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004458","url":null,"abstract":"<p><p>Pulmonary hypertension (PH) involves complex interactions between immune dysfunction and pulmonary vascular remodeling. Alveolar macrophages (AMs) are important regulators linking pulmonary immune responses to vascular pathology. However, AMs are not a homogeneous population and undergo dynamic functional reprogramming in response to chronic hypoxia, endothelial injury, metabolic stress, and extracellular matrix remodeling. This review summarizes current evidence on the mechanisms and pathological roles of AM heterogeneity in PH, focusing on cellular origin, microenvironmental regulation, transcriptional control, metabolic reprogramming, and intercellular crosstalk. We further discuss how distinct AM functional states contribute to chronic inflammation, pulmonary vascular remodeling, and disease progression. Importantly, we highlight AM state-specific regulation as a potential therapeutic strategy. Understanding AM heterogeneity as a dynamic process of functional adaptation may provide a new framework for elucidating immune mechanisms in PH and developing more precise therapeutic approaches.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}