Journal of Hypertension最新文献

{"title":"A case of plateau heart disease misdiagnosed as chronic pulmonary heart disease.","authors":"Na Zhang, Feng Tang","doi":"10.1097/HJH.0000000000004018","DOIUrl":"10.1097/HJH.0000000000004018","url":null,"abstract":"<p><p>This paper reports a case of plateau heart disease in Qinghai-Tibetan plateau who had recurrent symptoms of chest tightness and shortness of breath for 6 years but was misdiagnosed as chronic pulmonary heart disease. Plateau heart disease was diagnosed by thoracic computed tomography, pulmonary arteriography, pulmonary function tests and examination of medical history. Through the detailed analysis and differential diagnosis of this case, the aim is to distinguish between high-altitude heart disease and high-altitude chronic pulmonary heart disease, with the hope of achieving new breakthroughs in the diagnosis and treatment of this condition in the future.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1247-1251"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spironolactone protects against hypertension-induced renal fibrosis by promoting autophagy and inhibiting the NLRP3 inflammasome.","authors":"Lin Zhang, Jianchang Liu","doi":"10.1097/HJH.0000000000004020","DOIUrl":"10.1097/HJH.0000000000004020","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to investigate the mechanism by which spironolactone protects against hypertensive renal fibrosis.</p><p><strong>Methods: </strong>For in-vivo experiments, we established Control, SHR, and SHR+spironolactone (20 mg/kg/day) groups. For in-vitro experiments, we established Control, TGF-β1-induced (10 ng/ml), and spironolactone (1 μmol/l) intervention groups. Renal function and serum potassium, estradiol, testosterone, and plasma aldosterone levels were assessed, along with autophagy indicators LC3 and p62, and NLRP3 inflammasome-related proteins (NLRP3, Caspase-1, IL-1β and IL-18). Additionally, changes in macrophage polarization and T cell and dendritic cell populations were determined.</p><p><strong>Results: </strong>20 mg/kg/day of spironolactone effectively maintained systolic blood pressure and renal function by lowering aldosterone levels and significantly reducing testosterone levels. Hypertensive renal fibrosis was predominant in the glomeruli, tubules, and interstitium, and was associated with autophagy inhibition in renal tubules, NLRP3 inflammasome activation, both M1 and M2 macrophages polarization, with a predominant effect on M1 polarization, decreased CD4 + T cell population and CD4/CD8 ratio, and increased CD8 + T cell and dendritic cell population. Autophagy negatively regulated the NLRP3 inflammasome. Spironolactone inhibited both M1 and M2 macrophages polarization, mainly M1 macrophage polarization, reduced CD8 + T and dendritic cell population, increased CD4 + T cell population, negatively regulated the release of NLRP3 inflammasome-related proteins in macrophages, and restored autophagy in the glomeruli and renal tubules.</p><p><strong>Conclusion: </strong>Spironolactone acts on sites where the mineralocorticoid receptor is present. A dose of 20 mg/kg/day spironolactone is well tolerated and protects against hypertension-induced renal fibrosis by restoring autophagy and suppressing NLRP3 inflammasome activation.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1169-1181"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020916","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":"A young woman with severe renovascular hypertension due to essential thrombocytosis: case report and literature review.","authors":"Ankur Jain","doi":"10.1097/HJH.0000000000004031","DOIUrl":"10.1097/HJH.0000000000004031","url":null,"abstract":"<p><p>Essential thrombocytosis is characterized by the presence of microvascular and/or thrombo-hemorrhagic complications. The heart, brain, and peripheral vasculature are the most common sites for arterial thrombosis. Renal artery thrombosis (RAT) is uncommon in essential thrombocytosis patients. We report the case of a 27-year-old primigravida, who presented with accelerated hypertension during her early pregnancy. Despite four antihypertensive medications, her blood pressure (BP) remained uncontrolled. Radiological imaging revealed a left RAT. The presence of thrombocytosis prompted evaluation for essential thrombocytosis, which was confirmed after JAK2V617F positivity and corroborative bone marrow biopsy findings. The patient was deemed ineligible for renal angioplasty. Treatment with hydroxyurea and twice-daily aspirin resulted in BP control. A review of 13 cases of essential thrombocytosis with RAT was also presented. Essential thrombocytosis should be considered in the differential diagnosis of renovascular hypertension in young (< 40 years) women in the presence of thrombocytosis, and a history of prior/concurrent thrombosis or microvascular symptoms.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1252-1255"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025526","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":"Human umbilical cord mesenchymal stem cells improve the pregnancy outcomes of preeclampsia rats via inducing placental angiogenesis.","authors":"Panpan Zhao, Yuchen Zhang, Guang Zhang, Huan Niu, Jiao Li, Ruochen Hao, Mingkun Xie, Shuhui Chu, Xinyi Li, Genxia Li","doi":"10.1097/HJH.0000000000004022","DOIUrl":"10.1097/HJH.0000000000004022","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is considered to be a serious complication unique to pregnancy caused by placental dysplasia. Although interventions such as antihypertensive drugs and magnesium sulfate can partially mitigate maternal risk, the ultimate remedy remains delivery. In recent years, mesenchymal stem cells (MSCs) have become promising therapeutic approach in the treatment of ischemic diseases. Therefore, this study aimed to investigate the effect of human umbilical cord mesenchymal stem cells (hucMSCs) on pregnancy outcomes and placental angiogenesis in N-nitro-L-arginine methyl ester (L-NAME) induced preeclampsia rats.</p><p><strong>Methods: </strong>The expression of mesenchymal markers in hucMSCs was analyzed by flow cytometry. Multipotent differentiation of hucMSCs was identified, respectively. HucMSCs were injected into the preeclampsia rat by the tail vein. SBP was measured at the rat tail artery using an automatic noninvasive blood pressure monitor. The proteinuria levels were measured using the BCA method. RT-qPCR and ELISA were used to assess the mRNA expression and plasma concentrations of soluble FMS-like tyrosine kinase 1 (sFlt-1), placental growth factor (PLGF), and vascular endothelial growth factor (VEGF). Placental tissues were collected for immunohistochemistry and pathological analysis.</p><p><strong>Results: </strong>HucMSCs were positive for CD90, CD73, and CD105, and could differentiate into osteoblasts, adipocytes and chondrocytes. PE rats treated with hucMSCs showed a lowering of SBP and proteinuria and a higher fetal and placental mass. The microvascular density (MVD), mRNA expression, and plasma concentrations of VEGF and PLGF were increased in the hucMSCs-treated group, while the sFlt-1 levels were decreased.</p><p><strong>Conclusion: </strong>HucMSCs may promote placental angiogenesis and improve the pregnancy outcomes of preeclampsia rats by regulating the balance of pro-angiogenic and antiangiogenic factors.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1182-1190"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connecting the dots: renin-angiotensin-aldosterone system, vitamin D, and hypertension.","authors":"Huai Heng Loh, Elena Aisha Azizan, Norlela Sukor","doi":"10.1097/HJH.0000000000004046","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004046","url":null,"abstract":"<p><p>Both hyperaldosteronism and vitamin D deficiency are associated with increased cardiovascular morbidity and mortality. Evidence from animal studies highlights the regulatory role of vitamin D in the renin-angiotensin-aldosterone system (RAAS) and its implications for blood pressure control. However, human studies have yielded conflicting results. This narrative review presents a conceptual framework linking vitamin D deficiency to RAAS dysregulation in hypertension, emphasizing systemic and local regulatory mechanisms. We discuss the effects of vitamin D on renin suppression, aldosterone modulation, and parathyroid hormone interactions, as well as confounding factors contributing to variability in findings. Finally, we outline research priorities, including thresholds for vitamin D deficiency, genetic influences, and interventional strategies, to better understand this critical axis.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 7","pages":"1136-1145"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174052","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":"Editorial commentary on: \"assessing the relationship between short-term blood pressure variability and glycation profile in young and middle-aged nondiabetic hypertensive individuals\".","authors":"Mohammed Obeidat","doi":"10.1097/HJH.0000000000004041","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004041","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 7","pages":"1146-1147"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174059","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":"Optimizing benefits of intensive SBP control in type 2 diabetes: the crucial role of angiotensin-converting enzyme inhibitors/angiotensin-II type 2 receptor blockers.","authors":"Rui-Ting Lin, Jing-Wei Gao, Yong-Cong Yang, Xue-Wen Chen, Zhen-Jie Gu, Lei-Gang Tian, Zhe-Lin Chen, Ling-Yu Zhang","doi":"10.1097/HJH.0000000000004037","DOIUrl":"10.1097/HJH.0000000000004037","url":null,"abstract":"<p><strong>Aims: </strong>Intensive SBP control reduces major cardiovascular events (MACE) in patients with type 2 diabetes mellitus (T2DM) and hypertension, but no information regarding the preferred antihypertensive regimen could be available. The present study aims to investigate the most effective antihypertensive regimen for reducing MACE in these patients.</p><p><strong>Methods: </strong>Participants from the ACCORD BP trial with intensive SBP control were included. Cox proportional hazards models were used to analyze the effects of various antihypertensive regimens on MACE and all-cause mortality. Cost-effectiveness analysis was evaluated using the Markov model. Potential deaths averted were projected based on the referenced data from NHANES cohort.</p><p><strong>Results: </strong>A total of 2362 patients with T2DM and hypertension were included. ACEI/ARB-based antihypertensive regimen, but not other antihypertensive drugs-based ones, were associated with a reduced risk of MACE, and the protective efficiencies were similar across the whole cohort (standard and intensive glycemia control), intensive SBP control cohort [hazard ratio = 0.558, 95% confidence interval (95% CI): 0.420-0.741], standard glycemia/intensive SBP control cohort (hazard ratio = 0.563, 95% CI: 0.373-0. 850), and propensity score-matched standard glycemia/intensive SBP control cohort (hazard ratio = 0.522, 95% CI: 0.315-0.864). The protections were more prominent in patients with older age, CVD history, baseline SBP at least 140 mmHg, and higher Framingham score. All-cause mortality was also reduced with this regimen. Moreover, it was predicted to increase 2.18 quality-adjusted life years and to produce $29 611.97 net monetary benefit and was projected to prevent 494 742 deaths per year in the USA.</p><p><strong>Conclusion: </strong>In patients with hypertension and T2DM, ACEI/ARB is the mandatory antihypertensive medication if intensive SBP control implemented for better clinical benefits.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1214-1224"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024239","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":"Sex differences in blood pressure lowering of initial treatment with ultra-low dose combination therapy versus monotherapy. A secondary analysis of QUARTET.","authors":"Edel T O'Hagan, Simone L Marschner, Desi Quintans, Graham S Hillis, Emily R Atkins, Sarah Zaman, Markus P Schlaich, Anthony Rodgers, Clara K Chow","doi":"10.1097/HJH.0000000000004024","DOIUrl":"10.1097/HJH.0000000000004024","url":null,"abstract":"<p><p>Women with hypertension are more likely than men to have ineffective treatment where blood pressure (BP) is treated but not controlled. The aim of this study was to investigate whether a quadpill based strategy differs between males and females. A secondary analysis of The Quadruple UltrA-low-dose tReaTment for hypErTension (QUARTET); randomized controlled trial. In this analysis the primary outcome was sex differences in unattended office systolic BP at 12 weeks. The QUARTET study recruited 591 participants (40% female) with mean age 59 (standard deviation 12) years [male 57 (12); female 62 (11)]. Males and females recorded a similar reduction in unattended systolic BP at 12 weeks with no interaction between group allocation and sex [male:mean difference (MD) in mmHg -6.95 (95% CI -9.53 to -4.38), female: MD -6.34 (95% CI -9.50 to -3.18), interaction P  = 0.77]. The quadpill strategy was similarly effective in men and women. Initiating BP control with a quadpill in women presents a promising approach to achieving similar BP control levels to men.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1256-1260"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health financing interventions and hypertension control: a narrative review and hypothetical model.","authors":"Krishna D Rao, Matti Marklund, Rajeev Cherukupalli, Zhiqi Yao, Ahmad Khairul Abrar, Shamim Jubayer, Sohel Reza Choudhury, Lawrence J Appel, Kunihiro Matsushita","doi":"10.1097/HJH.0000000000004021","DOIUrl":"10.1097/HJH.0000000000004021","url":null,"abstract":"<p><p>Financial incentives have been used extensively in low-income and middle-income countries (LMICs) to improve health and service coverage. Little is known about their effectiveness in improving hypertension outcomes. We conducted a narrative literature review to document features of select supply-side (pay-for-performance, capitation) and demand-side [conditional cash transfers (CCT), vouchers] financing interventions focused on improving hypertension outcomes in primary care settings. Our review confirmed the paucity of studies, especially from LMICs. Pay-for-performance and capitation had small effects on screening, prescription practices, and blood pressure (BP) control. CCTs had mixed effects on screening and modest effects on BP control. Information on causal pathways, unintended consequences, and the use of vouchers was sparse. We then developed a conceptual model identifying pathways through which financing interventions influence hypertension outcomes. Based on this model, simulations in the context of Bangladesh indicated that pay-for-performance demands substantial financial resources but could become more favorable with increased treatment coverage.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1108-1115"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772289","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":"Antihypertensive drug treatment: are we ready for the future?","authors":"A H Jan Danser, Jaap Deinum","doi":"10.1097/HJH.0000000000004019","DOIUrl":"10.1097/HJH.0000000000004019","url":null,"abstract":"<p><p>Treatment of hypertension generally requires multiple antihypertensive drugs. Yet, not all patients are treated adequately, largely because of nonadherence, although drug ineffectiveness and counterbalancing mechanisms may also play a role. Novel antihypertensive drugs have not been introduced for at least one to two decades. Remarkably, over the last few years, a range of novel compounds is being introduced, acting either on novel targets, or displaying an exceptionally long half-life. The former may help to improve blood pressure lowering, for instance by interfering with counterbalancing mechanisms, while the latter might help to circumvent nonadherence. This review summarizes the latest developments, focusing on novel drugs acting on the endothelin system, the renin-angiotensin-aldosterone system (RAAS), and atrial natriuretic peptide (ANP).</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1099-1107"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753023","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}