Journal of Hypertension最新文献

{"title":"Abnormal blood pressure response to exercise and ventricular arrhythmias: a suspicious association in athletes.","authors":"Giuseppe Di Gioia, Armando Ferrera, Viviana Maestrini, Sara Monosilio, Maria Rosaria Squeo, Erika Lemme, Andrea Serdoz, Federica Mango, Antonio Pelliccia","doi":"10.1097/HJH.0000000000003936","DOIUrl":"10.1097/HJH.0000000000003936","url":null,"abstract":"<p><strong>Introduction: </strong>Abnormal blood pressure response to exercise (ABPR) in athletes is considered a risk for incident hypertension, conferring a higher cardiovascular risk profile. We sought to describe the clinical cardiovascular features of athletes with ABPR and, moreover, the relationship of ABPR with occurrence of exercise-induced ventricular ectopic beats (VEBs).</p><p><strong>Methods and results: </strong>We enrolled 1460 elite athletes (56.1% male; mean age 25.8 ± 5.1 years old), engaged in skills, power, mixed and endurance sport, who underwent clinical examination, transthoracic echocardiogram (TTE) and exercise stress testing. ABPR was defined as >220/85 mmHg in males and >200/80 mmHg in females. ABPR was found in 8% ( n  = 117) of athletes, being older ( P  = 0.049) and presenting higher cardiovascular risk profile (obesity, P  = 0.007; glucose intolerance, P  = 0.043 and familiarity for cardiovascular disease, P  = 0.026). Athletes with ABPR had higher prevalence of exercise-induced VEBs (19.6% vs. 11.9% in normotensive athletes, P  = 0.015). Uncommon VEBs morphology was more frequent in athletes with ABPR (64.7% vs. 19% in the normotensive, P  = 0.0002). Finally, in those with ABPR and VEBs, TTE revealed greater left ventricular end-diastolic diameter indexed ( P  = 0-006), LVEDVi ( P  = 0.017) and LVMi ( P  = 0.04) compared to those without VEBs.</p><p><strong>Conclusion: </strong>A not small group of elite athletes (8%) presented an exaggerated blood pressure response to exercise and exhibited higher cardiovascular risk profile compared to their normotensive counterparts. Moreover, athletes with ABPR showed higher prevalence of ventricular arrhythmias on effort and the combination of ABPR and ventricular arrhythmias was associated with more pronounced cardiac remodelling.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"513-520"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769732","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":"The relative contribution of hemodynamic parameters to blood pressure decrease in classical orthostatic hypotension.","authors":"Boriana S Gagaouzova, Amber van der Stam, Madeleine Johansson, Ineke A Van Rossum, Fabian I Kerkhof, Robert Reijntjes, Marc van Houwelingen, Roland D Thijs, Artur Fedorowski, J Gert van Dijk","doi":"10.1097/HJH.0000000000003832","DOIUrl":"10.1097/HJH.0000000000003832","url":null,"abstract":"<p><strong>Purpose: </strong>We studied the relative contributions of total peripheral resistance (TPR), stroke volume (SV) and heart rate (HR) to low blood pressure in classical orthostatic hypotension (cOH) on group and individual levels.</p><p><strong>Methods: </strong>We retrospectively analyzed tilt test records from cOH patients and age/sex-matched controls. We quantified relative effects of HR, SV and TPR on mean arterial pressure (MAP) with the log-ratio method. We studied relations of changes of HR, SV or TPR with the change of MAP across patients and variability of contributions of HR, SV and TPR to MAP. We also explored neurogenic vs. nonneurogenic causes.</p><p><strong>Results: </strong>MAP responded to tilt with a decrease in patients ( n  = 80) and an increase in controls ( n  = 80). A too small TPR-increase contributed most to cOH, followed by a too large SV-decrease; both effects were partially corrected by a larger increase of HR. Only TPR changes consistently affected MAP change in patients and controls. TPR decreased almost exclusively in patients, most in those with severe cOH. Contributions of HR, SV and TPR to MAP did not differ between probable neurogenic and nonneurogenic causes.</p><p><strong>Conclusion: </strong>HR, SV and TPR all contributed to cOH, with a key role for TPR; a decrease of TPR was almost unique to patients and may be due to hyperventilation. The lack of differences between neurogenic and nonneurogenic causes needs further study.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"436-444"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502027","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":"Serum autotaxin positively associates with hypertension in postmenopausal women: a single center study in China.","authors":"Jie Zhang, Jiayi Wang, Xuefeng Zhou, Shurong Chen, Yu Li, Yini Ke, Youming Li, Chaohui Yu, Yi Chen","doi":"10.1097/HJH.0000000000003922","DOIUrl":"10.1097/HJH.0000000000003922","url":null,"abstract":"<p><strong>Aim: </strong>Autotaxin is an adipokine involved in metabolic disorders. The aim of the current study was to evaluate serum autotaxin levels in hypertensive postmenopausal women and establish a relationship between autotaxin and other comorbidities in this special group.</p><p><strong>Methods: </strong>This single-center study included postmenopausal women who received annual health examinations at the First Affiliated Hospital, College of Medicine, Zhejiang University in Zhejiang, China. The metabolic and demographic characteristics of the subjects, including age, sex, height, weight, blood pressure, and biochemical indices, were collected. The serum autotaxin level was measured via ELISA. The Kolmogorov-Smirnov test, Student's t test, Mann-Whitney U test, χ2 test, receiver operating characteristic (ROC) curve analysis, Spearman correlation analysis and multivariate logistic regression analysis were adopted for statistical analysis.</p><p><strong>Results: </strong>This pilot observational study included 25 hypertensive postmenopausal women and 25 age-matched normotensive controls. Hypertensive patients presented significant metabolic disturbances with greater comorbidities such as nonalcoholic fatty liver disease, obesity, overweight, diabetes, hypertriglyceridemia and hyperuricemia ( P  < 0.05), impaired renal health with higher uric acid levels ( P  < 0.001), and slightly elevated creatinine levels ( P  = 0.156) with lower estimated glomerular filtration rates (eGFRs) ( P  = 0.195). The serum autotaxin level was markedly greater in the hypertensive group (239.0±59.6 ng/ml vs. 192.7 ± 49.0 ng/ml; P  < 0.01) and was positively associated with systolic blood pressure; diastolic blood pressure; and alanine transaminase, triglycerides (TG), creatinine, and uric acid levels and inversely associated with the eGFR ( P  < 0.05) among postmenopausal women. Serum autotaxin levels positively predicted hypertension, with an AU-ROC of 0.750 [95% confidence interval (CI): 0.613-0.888] and a Youden index of 0.480 at a cutoff of 225 ng/ml. In the multivariate logistic regression analysis, after adjustment for demographic and metabolic parameters (including age, BMI, ALT, TB, uric acid, FBG, TG, LDL and creatinine), autotaxin (ATX) remained independently positively correlated with the risk of hypertension [odds ratio: 1.016, 95% CI 1.001-1.031; P  < 0.05).</p><p><strong>Conclusions: </strong>Among postmenopausal women, the serum autotaxin level is significantly elevated in the hypertensive group compared with age-matched normotensive controls. ATX is related to multiple metabolic disorders and renal health, suggesting that autotaxin has potential as a multiorgan therapeutic target for cardiovascular-metabolic-renal disorders.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"420-427"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621957","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":"Differences in sex and age response to single pill combination based antihypertensive therapy reflecting in blood pressure and arterial stiffness.","authors":"Jana Brguljan Hitij, Zbigniew Gaciong, Dragan Simić, Péter Vajer, Parounak Zelveian, Irina E Chazova, Bojan Jelaković","doi":"10.1097/HJH.0000000000003901","DOIUrl":"10.1097/HJH.0000000000003901","url":null,"abstract":"<p><strong>Objective: </strong>There are noticeable sex differences in the treatment response to antihypertensives, with limited data on the response to single pill combinations. The aim of the PRECIOUS trial was to assess the treatment response to perindopril/amlodipine and perindopril/amlodipine/indapamide dual and triple single-pill combination in men and women.</p><p><strong>Methods: </strong>Four hundred and forty adults with essential hypertension were assessed in the 16-week interventional, open-label, prospective, international, multicentre trial. Based on the previous antihypertensive therapy, patients were assigned to either perindopril/amlodipine 4/5 mg or perindopril/amlodipine/indapamide 4/5/1.25 mg, with the initial dose up-titrated in 4-week intervals in case of uncontrolled blood pressure. An additional analysis was performed for sex- and age-related differences on the blood pressure response and arterial stiffness in men and women aged 35-74 years.</p><p><strong>Results: </strong>Women achieved better overall blood pressure control in all age groups, except for the 35-44 age group. Women presented higher average 24 h aortic augmentation indexes than men, but had more pronounced decreasing trends. The pulse wave velocity was only age-dependent, with reductions slightly greater in women. Both the aortic augmentation index and pulse wave velocity were significantly decreased in all groups compared to baseline.</p><p><strong>Conclusions: </strong>The results of the PRECIOUS trial contribute significant data to the expanding body of evidence on sex differences in hypertension, including the aspect of age-related changes during the life course of women. The differences between same-aged men and women tend to be smaller with advancing age, but with a greater treatment response in women in all age groups for all observed blood pressure parameters and arterial stiffness.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT03738761.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"387-396"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502043","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":"Independent and joint effect of central and brachial SBP on incident stroke in hypertensive adults.","authors":"Congcong Ding, Tianyu Cao, Zaihua Cheng, Lishun Liu, Zihan Chen, Wenyang Lu, Yaren Yu, Lan Gao, Chongfei Jiang, Yun Song, Junpei Li, Fangfang Fan, Yan Zhang, Jianping Li, Yong Huo, Hong Wang, Xiaobin Wang, Gianfranco Parati, Xiao Huang, Xiaoshu Cheng","doi":"10.1097/HJH.0000000000003921","DOIUrl":"10.1097/HJH.0000000000003921","url":null,"abstract":"<p><strong>Objective: </strong>It is unclear whether central SBP (cSBP) is an independent predictor of stroke above and beyond brachial SBP (bSBP). This study aimed to investigate the difference between cSBP and bSBP in predicting first stroke and the joint effect of cSBP and bSBP on the risk of first stroke in hypertensive adults.</p><p><strong>Methods: </strong>A total of 8122 hypertensive adults without stroke history were included in this study. cSBP was measured noninvasively using A-Pulse CASPro device. The outcome was first stroke. During a median follow-up of 4.4 years, 579 first strokes were identified.</p><p><strong>Results: </strong>A total of 8122 hypertensive adults without stroke history were included in this study. cSBP was measured noninvasively using A-Pulse CASPro device. The outcome was first stroke. During a median follow-up of 4.4 years, 579 first strokes were identified. The risk of first stroke increased by the same 16% [hazard ratio: 1.16, 95% confidence interval (95% CI): 1.07-1.26] for per SD increment in both cSBP and bSBP. The differences in areas under the curves, continuous net reclassification indices, and integrated discrimination indices of bSBP and cSBP models for predicting first stroke were 0.003 (95% CI: -0.003, 0.008), 0.007 (95% CI: -0.058, 0.071), and -0.0002 (95% CI: -0.0028, 0.0013), respectively. When cSBP and bSBP were evaluated jointly, participants in the highest tertiles of both cSBP and bSBP had the highest risk of first stroke compared with their counterparts (hazard ratio: 1.59, 95% CI: 1.29-1.96; P -interaction = 0.034). Similar results were found for ischemic stroke and hemorrhagic stroke.</p><p><strong>Conclusion: </strong>Although cSBP was not found to be superior to bSBP in predicting first stroke, cSBP and bSBP were jointly associated with the risk of first stroke among hypertensive adults.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"428-435"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710264","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":"Two-hit model for the development of aldosterone-producing adenoma: supporting from two new cases.","authors":"Yinjie Gao, Yu Wang, Yue Zhou, Jie Ding, Xiaoyan Chang, Ling Qiu, Li Huo, Jin Wen, Yushi Zhang, Anli Tong","doi":"10.1097/HJH.0000000000003888","DOIUrl":"10.1097/HJH.0000000000003888","url":null,"abstract":"<p><p>Recently, a two-hit model for the development of aldosterone-producing adenoma (APA) was proposed but until now, only two cases supporting the model have been reported. Here, we present two new cases of primary aldosteronism (PA), both of which had large functional adenomas with somatic mutations in aldosterone-driving genes. Furthermore, the first patient, who had a history of colorectal cancer, was found to have a germline and an additional somatic mutation in APC , and APC inactivation was confirmed by immunohistochemistry. The other patient had pathogenic somatic mutation in CTNNB1 . These pro-proliferation mutations resulted in abnormal activation of the Wnt/β-catenin pathway. Two consecutive events apparent in these patients, namely, the first event leading to cell proliferation and the second driving hormonal hypersecretion, supported the two-hit model of APA development. The two-hit model usually occurs in the larger adenomas, and the driving factors of the first hit that promote cell proliferation still require further research and exploration.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"544-548"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502028","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":"Remission of persistent hypertension and hypokalaemia following redo adrenalectomy for primary aldosteronism - case report.","authors":"Diluka Pinto, Ada Teo, Sujith Wijerethne, Chin Meng Khoo, Troy Puar, Rajeev Parameswaran","doi":"10.1097/HJH.0000000000003944","DOIUrl":"10.1097/HJH.0000000000003944","url":null,"abstract":"<p><p>We report on a case of a 67-year-old male who was referred to our care with persistent aldosteronism post adrenalectomy. Biochemical failure after surgery is rare after surgery for primary aldosteronism (PA). Persistent hypokalaemia and raised aldosteronism is an indication of treatment failure after surgery. Causes of failure may be multiple aldosterone producing nodules or diffuse hyperplasia, inappropriate or incomplete lateralization studies, presence of CACNA1D -mutated aldosterone producing adenomas (APAs) and incomplete or partial adrenalectomy. In our case the persistent disease was imaged with METOMIDATE PET as the patient had a previous history of adrenal vein clipping during index surgery. The patient underwent reoperative adrenalectomy and was cured of hypokalaemia and hypertension, despite a long duration of his disease. This case highlights some of the reasons for biochemical failure and work up of the patient for reoperative surgery.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"549-552"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949979","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":"Sedentary behavior modified the association between depression and risk of all-cause deaths in hypertensive population.","authors":"Haixu Wang, Zeming Zhou, Lihua Zhang, Fang Yu, Jingkuo Li, Lubi Lei, Zhenyan Zhao, Jie Zhao","doi":"10.1097/HJH.0000000000003929","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003929","url":null,"abstract":"<p><strong>Objective: </strong>The pathogenic mechanism of depression involves chronic inflammation, which can be affected by sedentary behavior. This study aimed to determine whether sedentary behavior modified the association between depression and risk of death in the hypertensive population.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (2007-2018) was analyzed. Depression was assessed through the Health Questionnaire-9, and sedentary behavior was evaluated using self-reported sitting hours in a day. Deaths were ascertained through the National Death Index until 31 December 2019. The interaction effect was evaluated through multivariable Cox regression analysis.</p><p><strong>Results: </strong>Eight thousand one hundred and twenty-four patients with hypertension were involved in the study. During a median follow-up of 7.3 years, we confirmed 1384 all-cause and 373 cardiovascular deaths. Separate analyses revealed that both depression and sitting for 6 h per day or more were correlated with increased risks of all-cause and cardiovascular deaths. Of note, we found that sitting time modified the link between depression and the risk of all-cause death (P for interaction: 0.02). Compared with the nondepression group, the depression group was correlated with an elevated risk of all-cause death among participants with sitting time of more than 6 h/day [hazard ratio 1.52, 95% confidence interval (CI) 1.22-1.91, P < 0.001], but not among participants with sitting time of less than 6 h/day (hazard ratio 0.95, 95% CI 0.65-1.39, P = 0.76).</p><p><strong>Conclusion: </strong>Sedentary behavior modified the link between depression and the risk of all-cause death. Reducing sedentary time might attenuate the detrimental effects of depression on survival in the hypertensive population.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 3","pages":"474-480"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066101","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":"Association of diastolic blood pressure and coronary artery calcium in South Asian American adults.","authors":"Meena Moorthy, Namratha R Kandula, Nicola Lancki, Juned Siddique, Neela Thangada, Daichi Shimbo, Havisha Pedamallu, Alka M Kanaya, Nilay S Shah","doi":"10.1097/HJH.0000000000003940","DOIUrl":"10.1097/HJH.0000000000003940","url":null,"abstract":"<p><strong>Objective: </strong>Diastolic blood pressure (DBP) is associated with atherosclerosis and cardiovascular disease, independent of systolic blood pressure (SBP). However, prior evaluation of the association of DBP with coronary artery calcium (CAC) has not included South Asian adults, a population that is at excess risk of atherosclerotic cardiovascular disease.</p><p><strong>Methods: </strong>In the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study, we evaluated the association of sex-specific DBP tertiles and CAC score > = 100 with robust Poisson regression adjusted for age, sex, SBP, BP medication use, and other cardiovascular risk factors. We examined these associations stratified by antihypertensive medication use, and secondarily the association of baseline DBP tertile with incident CAC over median 4.7 years of follow-up.</p><p><strong>Results: </strong>Among 1155 participants (48% women, mean age 57 years), mean (standard deviation) DBP was 74 (10) mmHg, 33% were on antihypertensive medications, and 22% had CAC > = 100. Relative to DBP in tertile 1, DBP in tertiles 2 and 3 was associated with a significantly higher prevalence of CAC > = 100 [adjusted prevalence ratio 1.30 [95% confidence interval (CI) 1.03-1.65] and 1.47 (1.12-1.93), respectively]. These significant associations were primarily observed in participants who were not on antihypertensive medications. Baseline DBP tertile was not associated with incident CAC.</p><p><strong>Conclusion: </strong>Among South Asian adults in MASALA, DBP in the second or third tertiles vs. tertile 1 were associated with a higher prevalence of CAC > = 100 after adjustment for covariates, including SBP. DBP may be an important clinical ASCVD risk factor among South Asian adults.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"538-543"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769733","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":"Predicting blood pressure response to renal denervation based on a new approach.","authors":"Venera Bytyqi, Dennis Kannenkeril, Kristina Striepe, Agnes Bosch, Marina V Karg, Axel Schmid, Mario Schiffer, Michael Uder, Roland E Schmieder","doi":"10.1097/HJH.0000000000003918","DOIUrl":"10.1097/HJH.0000000000003918","url":null,"abstract":"<p><strong>Background: </strong>Identifying predictors of blood pressure (BP) response to renal denervation (RDN) is crucial for patient selection. According to Wilder's principle, baseline BP predicts BP change after any antihypertensive intervention. Thus, any observed BP change after RDN is the sum of the BP change depending on the baseline BP and the specific BP reduction due to RDN. Based on this concept, we propose a new definition of BP responders.</p><p><strong>Methods: </strong>In our center, 148 patients with uncontrolled hypertension underwent RDN, and 24-h ambulatory BP (ABP) was measured at baseline, and 6 months after the procedure. The decrease in 24-h systolic BP (SBP) correlated with baseline SBP ( P  = <0.001, r  = -0.374). We determined the RDN-specific effect by subtracting the predicted SBP decrease from the observed SBP decrease. The cohort was divided into RDN responders, neutral responders, and nonresponders.</p><p><strong>Results: </strong>Our study population had a mean age of 59 ± 10.4 years and was 74% male. The RDN-specific (residual) 24-h ABP decreased by -14.9 ± 6.3/-8.2 ± 3.8 mmHg (responder group), 1.0 ± 3.2/0.2 ± 1.9 mmHg (neutral group), and 14.2 ± 10.4/8.3 ± 3.9 mmHg (nonresponder group) 6 months after RDN. Responders had fewer antihypertensive medications ( P  = 0.018), higher baseline office heart rate (HR) ( P  = 0.019), higher 24-h ambulatory HR ( P  = 0.003), lower BMI ( P  < 0.038), and absence of type 2 diabetes (T2D) ( P  = 0.020).</p><p><strong>Conclusion: </strong>Our definition of BP responders to RDN separates baseline BP-related changes from RDN-specific changes. Positive predictors for BP response to RDN include low BMI, fewer antihypertensive medications, high baseline office HR, high 24-h ambulatory HR, and absence of T2D.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"413-419"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621954","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}