Journal of Hypertension最新文献

{"title":"Impact of mild autonomous cortisol secretion on metabolism & cardiac morphology in adrenal incidentaloma.","authors":"Yanan Li, Jiang Liu, Xin Zhao, Yushi Zhang","doi":"10.1097/HJH.0000000000004306","DOIUrl":"10.1097/HJH.0000000000004306","url":null,"abstract":"<p><strong>Objectives: </strong>Mild autonomous cortisol secretion (MACS) leads to the clustered manifestations of hypertension (HT), diabetes, and metabolic syndromes. However, whether the effect of MACS on myocardial remodeling and cardiac function is similar to that of Cushing's syndrome remains unclear. This study aimed to compare the metabolic risks and impact on cardiac structure and function between MACS and Cushing's syndrome.</p><p><strong>Methods: </strong>This retrospective study evaluated patients with nonfunctioning adrenal tumors (NFAT), MACS, and Cushing's syndrome. Metabolic parameters and cardiac structure/function indices were compared among the groups.</p><p><strong>Results: </strong>Overall, 208 patients with NFAT ( n  = 20), MACS ( n  = 108), and Cushing's syndrome ( n  = 80) were included. HT, diabetes, and metabolic syndrome were significantly more prevalent in the MACS group than in the NFAT group. Compared with the NFAT group, the MACS group showed significantly higher left ventricular mass index (LVMI) ( P  = 0.011) and rates of pathological LVMI elevation ( P  = 0.025). LVMI was significantly higher in both the MACS ( P  = 0.002) and Cushing's groups ( P  < 0.001) than in the NFAT group. Meanwhile, the metabolic parameters and LVMI were not significantly different between the MACS and Cushing's groups.</p><p><strong>Conclusions: </strong>Autonomous cortisol secretion (ACS), including MACS, is associated with higher metabolic risk and LVMI than is NFAT. The metabolic risk and LVMI elevation in MACS are comparable to those in Cushing's syndrome. Hence, all patients with ACS require clinical attention, regardless of the clinical manifestations.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1149-1154"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972731","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":"Orthostatic blood pressure transitions: Association with symptoms and frailty.","authors":"Edmur C A Filho, Fernando Yue Cesena, Bruno N Blaas, Magno M P de Faria, Sarah T de Biaso, Caroline Y Yoshioka, Mário S C Pires, Rogerio M C Britto, Marcio G de Sousa, Fernanda M Consolim-Colombo, Jonathan B Souza, Antônio Gabriele Laurinavicius","doi":"10.1097/HJH.0000000000004325","DOIUrl":"10.1097/HJH.0000000000004325","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with hypertension may transition between different orthostatic blood pressure (BP) phenotypes within minutes. We studied the temporal patterns of orthostatic BP responses and their relationship to symptom development in older hypertensive individuals with and without frailty.</p><p><strong>Design and method: </strong>A cross-sectional study was conducted, including patients aged at least 60 years. BP was measured seated and at 1 and 3-min post-standing. Orthostatic hypotension and orthostatic hypertension (OHT) were defined in accordance with current guidelines. Orthostatic intolerance was defined as symptoms upon standing. Frailty was assessed using the Clinical Frailty Scale. Multivariable logistic regression models evaluated associations between orthostatic BP phenotypes, orthostatic intolerance and Frailty.</p><p><strong>Results: </strong>We included 461 hypertensive adults (mean age: 72.5 ± 7.0 years, 70% women). The prevalence of orthostatic hypotension and OHT was 11 and 10%, respectively. About 50% of individuals with orthostatic hypotension or OHT at minute 1 normalized their BP by minute 3, while a similar absolute number with normal BP at minute 1 developed orthostatic hypotension or OHT by minute 3. Frail individuals exhibited a twofold higher prevalence of orthostatic hypotension [odds ratio (OR) 2.39, P  = 0.023], and a more than threefold higher prevalence of OHT (OR 3.60, P  < 0.001). In fully adjusted models, orthostatic intolerance was associated with both systolic orthostatic hypotension (OR 3.05, P  = 0.019) and OHT (OR 2.33, P  = 0.041).</p><p><strong>Conclusion: </strong>Orthostatic BP phenotypes in hypertensive older adults were dynamic, with frequent shifts between 1 and 3 minutes of standing. Frailty and OI were strongly associated not only with OH but also with OHT.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1247-1253"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972959","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":"Prevalence of masked hypertension in patients with diabetes: a study in Mozambique.","authors":"Valério Govo, Ângela Mateus, Célia Novela, Paula Caupers, Sandra Loureiro, Nuno Lunet, Albertino Damasceno","doi":"10.1097/HJH.0000000000004313","DOIUrl":"10.1097/HJH.0000000000004313","url":null,"abstract":"<p><strong>Background: </strong>Patients with type 2 diabetes mellitus (T2DM) are at an increased risk of masked hypertension (normal office blood pressure with increased out-of-office readings) and its cardiovascular complications. However, data from Africa remain scarce.</p><p><strong>Objectives: </strong>To describe the occurrence of masked hypertension and its associated factors among Black patients with T2DM.</p><p><strong>Methods: </strong>Patients with T2DM diagnosed for at least 1 year, with office SBP less than 140 mmHg and DBP less than 90 mmHg and not under antihypertensive treatment were consecutively selected from primary healthcare and outpatient clinics, in Maputo and Matola cities in Mozambique. All participants underwent both office and 24-h ambulatory blood pressure (ABPM) measurements. Aortic stiffness was assessed using pulse wave velocity (PWV).</p><p><strong>Results: </strong>The prevalence of 24-h masked hypertension (95% confidence interval) was 53% (42.8-63.1), being 50% (39.8-60.2) for daytime and 63% (52.8-72.4) for nighttime masked hypertension. The prevalence reached 73% among those with an office SBP greater than 130 mmHg [age-adjusted odds ratio (OR) vs. <120 mmHg = 3.40, P = 0.041] and 82% among those with PWV > 12 m/s (age-adjusted OR vs. <10 m/s = 6.90, P = 0.003).</p><p><strong>Conclusion: </strong>Over half of Black patients with T2DM and normal office blood pressure had masked hypertension, which was significantly associated with high office SBP values and increased arterial stiffness. These findings highlight the elevated risk of masked hypertension among Black patients with T2DM and the importance of identifying high-risk individuals for ABPM, particularly in resource-limited settings.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 7","pages":"1197-1204"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031476","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":"Effects of dapagliflozin and dulaglutide on blood pressure and coronary flow in liver steatosis patients with type 2 diabetes.","authors":"Ignatios Ikonomidis, Eleni Michalopoulou, George Pavlidis, Panagiota Efstathia Nikolaou, Konstantinos Katogiannis, Vasiliki Prentza, John Thymis, Dimitrios Vlachomitros, Eleni Katsanaki, Gavriella Kostelli, Emmanouil Korakas, Loukia Pliouta, Aikaterini Kountouri, Dimitrios Kypraios, Dimitrios Dimitroulopoulos, Evangelos Oikonomou, Gerasimos Siasos, Ioannis S Papanikolaou, Vaia Lambadiari","doi":"10.1097/HJH.0000000000004311","DOIUrl":"10.1097/HJH.0000000000004311","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) on cardiovascular function and hepatic metabolism in patients with type 2 diabetes mellitus (T2DM) and metabolic-dysfunction associated steatotic liver disease (MASLD).</p><p><strong>Methods: </strong>This is an unblinded real-world study using propensity score analysis of consecutive patients with T2DM and MASLD received either SGLT-2i (dapagliflozin; n = 21), GLP-1RA (dulaglutide; n = 21), or dipeptidyl peptidase-4 inhibitors (DPP-4i; n = 20). At baseline and after 12 months, we assessed the perfused boundary region (PBR) as a marker of glycocalyx thickness, peripheral and central systolic blood pressure (cSBP), pulse wave velocity (PWV), coronary flow reserve (CFR), left ventricular global longitudinal strain (GLS), controlled attenuation parameter (CAP), and liver stiffness (E).</p><p><strong>Results: </strong>At 12 months, all patients had reduced glycosylated hemoglobin and body mass index compared to baseline (P < 0.001), as well as a significant reduction in cSBP, PBR, PWV, CAP, E, and increase in CFR and GLS (P < 0.01). The percentage decrease in peripheral and central SBP was related with the improvement in PBR, PWV, CFR, and GLS at 12 months (P < 0.01). Dulaglutide showed greater improvement in GLS (22.6% vs. 8.5%, vs. 5.9%, P = 0.015) and PBR (P = 0.037) than dapagliflozin and DDP-4i. Both dulaglutide and dapagliflozin showed a greater increase in CFR than DDP-4i post-treatment. The percentage reduction in CAP was associated with the decrease in PBR, PWV and with the increase in GLS (P < 0.05).</p><p><strong>Conclusion: </strong>Twelve-month treatment with either SGLT-2i or GLP-1RA improves central hemodynamics, coronary flow and reduces hepatic steatosis in T2DM individuals with MASLD.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 7","pages":"1173-1184"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031154","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":"Mineralocorticoid receptor antagonists and mortality in hypertension: a systematic review and meta-analysis.","authors":"Jia Wei Teh, Gavin Comerford, Garvin Surlis, James Curneen, Finn Krewer, Andrew Smyth, David Lappin, John William Mcevoy, Michael Conall Dennedy, Conor Judge","doi":"10.1097/HJH.0000000000004323","DOIUrl":"10.1097/HJH.0000000000004323","url":null,"abstract":"<p><strong>Background: </strong>International guidelines differ in their recommendations for mineralocorticoid receptor antagonist (MRA) use in hypertension, as the effect on mortality is unclear. We meta-analyzed trial-level data to determine the association of MRA use with all-cause mortality in hypertension.</p><p><strong>Methods: </strong>MEDLINE and EMBASE were searched for randomized clinical trials published from database inception through March 14, 2025, evaluating MRA use in trial populations with at least 85% prevalence of hypertension. The control groups consisted of placebo or usual care. Two reviewers independently screened and extracted data. Pooled estimates were calculated using random-effects and inverse variance models. The primary outcome was all-cause mortality.</p><p><strong>Results: </strong>Seventeen randomized clinical trials were eligible for inclusion ( n   =  25 498), of which 12 trials reported mortality events ( n   =  24 426). The mean (±SD) baseline prevalence of hypertension was 95.0% (±5.0), mean baseline SBP was 134.8 (±9.0) mmHg, mean age was 64.1 (±5.3) years and 43.3% ( n   =  11 047) were female. The median duration of follow-up was 12 months (interquartile range 9-32 months). MRA use versus control was significantly associated with lower odds of all-cause mortality (12 trials, n   =  24 426) (10.7 versus 11.6% over a median follow-up of 20.5 months; odds ratio (OR), 0.91 [95% confidence interval, 95% CI, 0.84-0.99]; absolute risk reduction, 0.88% [95% CI, 0.1-1.7]; I2   =  0.0%).</p><p><strong>Conclusion: </strong>In this meta-analysis of randomized clinical trials in predominantly hypertensive populations with substantial comorbidity, MRA use was significantly associated with lower all-cause mortality. Further dedicated trials in hypertensive populations, with longer follow-up and mortality as primary outcome, are warranted to confirm these findings. (PROSPERO; CRD420250601811).</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1238-1246"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838381","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":"Utility of the post-cosyntropin urinary metabolomic profile for the subtype diagnosis of primary aldosteronism.","authors":"Marta Araujo-Castro, Felicia A Hanzu, Jessica Goi, Cristina Lamas, Ana M García Cano, Ángel Rebollo-Román, Manuel Morales-Ruiz, Fernando Sebastian-Valles, Mónica Marazuela, Héctor F Escobar-Morreale, Gregori Casals","doi":"10.1097/HJH.0000000000004329","DOIUrl":"10.1097/HJH.0000000000004329","url":null,"abstract":"<p><strong>Objective: </strong>To analyze if differences between patients with unilateral (UPA) and bilateral primary aldosteronism (BPA) in baseline and cosyntropin-stimulated urinary steroid metabolomic profile (USMP), might serve to identify patients in whom adrenal venous sampling (AVS) could be avoided because of a low probability of UPA.</p><p><strong>Methods: </strong>A prospective, multicenter study of patients consecutively diagnosed with primary aldosteronism with a known source of aldosterone based on AVS and/or surgical outcomes. Thirty-three urinary steroid metabolite levels were measured before and after 250 μg intravenous cosyntropin.</p><p><strong>Results: </strong>Thirty-one patients with UPA and 20 with BPA were enrolled. Patients with UPA had a shorter duration of hypertension ( P  = 0.048) and a tendency towards a higher prevalence of hypokalemia ( P  = 0.056). The absolute increase of cortisol after cosyntropin infusion ( P  = 0.130) tended to be lower in UPA cases than in those with BPA. In the post-cosyntropin USMP, cortisone levels were lower in UPA than BPA (median: 289 vs. 395 μg/24 h, P  = 0.034). The predictive model that combines post- cosyntropin 24 h urinary cortisone levels, hypokalemia, and Δserum cortisol post- cosyntropin provided a diagnostic accuracy of 73% for differentiating UPA and BPA [Area under the ROC curve (AUC) 0.728, 95% confidence interval (CI) 0.565-0.840]. The probability of UPA was low (17.3%) in patients with normokalemia, post-cosyntropin cortisone levels greater than 384 μg/24 h, and serum cortisol greater than 14 μg/dl.</p><p><strong>Conclusion: </strong>The probability of UPA is lower than 18% in patients with normokalemia, post-cosyntropin 24 h urinary cortisone greater than 384 μg/24 h and serum cortisol increase with cosyntropin greater than 14 μg/dl. Thus, AVS might be avoided in these patients, and targeted medical therapy can be initiated with no further procedures.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1264-1275"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982076","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":"Acute blood pressure reduction exceeding safety and autoregulatory limits following rapid-acting antihypertensives for hypertensive urgency.","authors":"Richard A Preston, Evelyn V Caizapanta, David Afshartous, Langely Chaparro, Pamella A M Bueno, Gisselle Jimenez, Phillip Rubin, Jeffrey N Bernstein","doi":"10.1097/HJH.0000000000004304","DOIUrl":"10.1097/HJH.0000000000004304","url":null,"abstract":"<p><strong>Introduction: </strong>Severe hypertension without associated hypertensive target organ injury is termed hypertensive urgency. Treatment guidelines for the initial 4-6 hours uniformly warn against extreme (e.g. >80 mmHg) reduction in SBP and reduction more than 25% below baseline mean arterial pressure (MAP), the approximate lower limit of cerebral autoregulation. We hypothesized that rapid-acting antihypertensive regimens commonly employed for hypertensive urgency can reduce SBP and MAP in excess of these limits, potentially compromising cerebral blood flow.</p><p><strong>Methods: </strong>Retrospective cohort study in 1553 patients with hypertensive urgency to assess 5-hour SBP and MAP responses to the most commonly administered single-drug regimens ( n  = 453), combined single-drug and multiple-drug regimens ( n  = 1051), and no drug ( n  = 199). Co-primary endpoints: number (%) SBP reduction greater than 80 mmHg and number (%) MAP reduction more than 25%.</p><p><strong>Results singledose: </strong>rapid-acting oral clonidine ( n  = 214), intravenous hydralazine ( n  = 93), and intravenous labetalol ( n  = 40), produced 5-hour SBP reduction of more than 80 mmHg in 38/214 (18%), 17/93 (18%), and 8/40 (20%) patients, respectively, and MAP reduction of more than 25% in 98/214 (46%), 41/93 (44%), and 15/40 (38%) patients, respectively. Conversely, oral extended-release nifedipine ( n  = 84) and oral lisinopril ( n  = 22) produced SBP reduction of more than 80 mmHg in 1/84 (1%) and 1/22 (5%) patients. MAP reductions of more than 25% were also fewer: 18/84 (21%) and 2/22 (9%) patients.Combined single-drug/multidrug combinations ( n  = 1051) and no drug ( n  = 199) demonstrated similar excessive SBP and MAP reductions.</p><p><strong>Discussion: </strong>Our results demonstrate frequent extreme SBP and MAP reductions exceeding safety and autoregulatory limits with rapid-acting antihypertensives and the crucial need to develop and test novel clinical algorithms for the well tolerated and effective management of hypertensive urgency.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1137-1148"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592608","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 between the cumulative average triglyceride glucose-BMI and hypertension incidence among the middle-aged and older population: a prospective nationwide cohort study in China.","authors":"Xiaoxiao Hou, Ying Chen, Qi Wang, Yuqi Sun, Shan Tong, Kai Liu","doi":"10.1097/HJH.0000000000004312","DOIUrl":"10.1097/HJH.0000000000004312","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to prospectively examine the association between triglyceride glucose-BMI (TyG-BMI) and hypertension incidence in a middle-aged and older Chinese population.</p><p><strong>Methods: </strong>We conducted a prospective analysis of 3614 participants without baseline hypertension from the China Health and Retirement Longitudinal Study (CHARLS). Cumulative average TyG-BMI was calculated from measurements taken in 2011 (Wave 1) and 2015 (Wave 3). Incident hypertension was defined as new physician diagnosis, antihypertensive medication use, or measured blood pressure at least 140/90 mmHg during follow-up. Multivariable Cox models and restricted cubic splines were used to assess the association. Sensitivity analyses, including propensity score matching, and subgroup analyses were performed.</p><p><strong>Results: </strong>During a mean follow-up of 60 months, 737 participants developed incident hypertension. The cumulative incidence increased steadily across quartiles of cumulative average TyG-BMI. In the fully adjusted Cox model, participants in the highest quartile had a significantly higher risk of hypertension compared with those in the lowest quartile [adjusted hazard ratio 2.095, 95% confidence interval (95% CI) 1.641-2.674; P for trend <0.001]. When analysed as a continuous variable, each 1-SD increment in cumulative average TyG-BMI was associated with a 30.6% higher hypertension risk (adjusted hazard ratio 1.306, 95% CI 1.198-1.425; P  < 0.001). Restricted cubic spline analyses demonstrated a significant positive linear association without evidence of nonlinearity ( P for nonlinearity = 0.112). The association remained robust across subgroup analyses and sensitivity analyses, including exclusion of early incident cases and propensity score matching.</p><p><strong>Conclusion: </strong>Higher cumulative average TyG-BMI exposure is independently and linearly associated with increased hypertension risk in middle-aged and older Chinese adults. As a simple integrative indicator, cumulative TyG-BMI shows significant potential for risk stratification and early hypertension prevention in primary care.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1185-1196"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941579","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":"Association between high likelihood of obstructive sleep apnea and masked hypertension: findings from the Jackson heart and coronary artery risk development in young adults studies.","authors":"Marwah Abdalla, Bharat Poudel, Swati Sakhuja, Brandon Fernandez-Sedano, Michelle L David, Sumayya Shurovi, Mark J Butler, Shakia T Hardy, Chandra L Jackson, Dayna A Johnson, See Ling Loy, Gbenga Ogedegbe, Joseph E Schwartz, James M Shikany, Daichi Shimbo, Mario Sims, Tanya M Spruill, Carmen D Tekwe, S Justin Thomas, Natasha J Williams, Roger S Zoh, Susan Redline, Paul Muntner","doi":"10.1097/HJH.0000000000004314","DOIUrl":"10.1097/HJH.0000000000004314","url":null,"abstract":"<p><strong>Objective: </strong>Masked hypertension [nonhigh office blood pressure (BP) and high out-of-office BP] is associated with cardiovascular risk. Obstructive sleep apnea (OSA) is associated with high office BP, but few data exist on its association with masked hypertension, especially in Black adults who have a high prevalence of both conditions.</p><p><strong>Methods: </strong>We analyzed pooled data from 1078 Black adults, 713 in the Jackson Heart Study and 365 in the Coronary Artery Risk Development in Young Adults study, with office BP less than 140/90 mmHg, who completed 24-h ambulatory BP monitoring. Masked hypertension was defined as mean awake BP at least 135/85 mmHg, asleep BP at least 120/70 mmHg, or 24-h BP at least 130/80 mmHg. A high likelihood of OSA was defined using sleep questionnaires and physical measurements. Poisson regression was used to estimate prevalence ratios, adjusting for demographics, lifestyle behaviors, and comorbidities. Analyses were stratified by antihypertensive medication use.</p><p><strong>Results: </strong>Overall, 34% of participants had a high likelihood of OSA; 53.3% had masked hypertension. Among participants not taking antihypertensive medication ( n  = 505), adjusted prevalence ratios comparing those with versus without a high likelihood of OSA were 1.31 [95% confidence interval (CI) 1.06-1.61], 0.88 (95% CI 0.59-1.29), 1.37 (95% CI 1.09-1.73), and 1.35 (95% CI 1.00-1.83) for any, awake, asleep, and 24-h masked hypertension. Among those taking antihypertensive medication ( n  = 573), the adjusted prevalence ratios were 1.15 (95% CI 0.99-1.32), 1.04 (95% CI 0.83-1.31), 1.14 (95% CI 0.97-1.33), and 1.19 (95% CI 0.96-1.47), respectively.</p><p><strong>Conclusion: </strong>A high likelihood of OSA was associated with a higher prevalence of masked hypertension among participants not taking antihypertensive medication.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1205-1213"},"PeriodicalIF":5.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773617","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":"Characteristics of children and adolescents with fibromuscular dysplasia: a systematic review and meta-analysis.","authors":"Weiwei Wang, Małgorzata Podymniak-Grzeszykowska, Tom Robberechts, Nadejda Ranguelov, Sophie Pierard, Mieczysław Litwin, Maria Simona Stoenoiu, Alexandre Persu","doi":"10.1097/HJH.0000000000004318","DOIUrl":"10.1097/HJH.0000000000004318","url":null,"abstract":"<p><p>Based on data from large international registries, the clinical presentation of fibromuscular dysplasia (FMD) in adult patients is now well established. By contrast, characteristics of FMD in children and adolescents remain poorly described. We present the first systematic review and meta-analysis focused on pediatric FMD. Seven databases were searched for studies published since 2000. Data were pooled using random-effects models. Subsequently, the characteristics of pediatric FMD patients were compared with those of adult patients included in the US and FEIRI registries. Nine retrospective studies totalizing 218 children/adolescents with FMD were identified. All had renal FMD and 93.7% were revascularized. The mean age at diagnosis was 11.7 years. Fifty-two % were females (U.S. Registry 94.7%; FEIRI 81.5%). Most patients (66.6%) had focal FMD (U.S. Registry 24.0%; FEIRI 28%). Despite incomplete screening, multivessel FMD was identified in 19.1% (U.S. Registry 55.1%; FEIRI 57.4%), and aneurysms and dissections in 15.3% and 1.7%, respectively (U.S. Registry 22.7%, 28.1%; FEIRI 21.6%, 5.6%). The proportion of mid-aortic syndrome (MAS) was 6.3%. In ethnicity-stratified analyses, the female proportion was 43.6% in Asian vs. 58.1% in Caucasian children, and the prevalence of multifocal FMD was 21.8% vs. 37.9%. In conclusion, compared with adult patients, children/adolescents with FMD are characterized by a lower proportion of females and a higher proportion of focal FMD, both in Asians and Caucasians. While associated MAS appears less frequent than previously thought, multivessel involvement and aneurysms were frequently reported, suggesting the interest of a systematic arterial exploration in children with FMD, as recommended in adults.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1079-1086"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973024","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}