Journal of Hypertension最新文献

{"title":"The impact of the COVID-19 pandemic on blood pressure control in patients with treated hypertension-results of the European Society of Hypertension Study (ESH ABPM COVID-19 Study).","authors":"Wiktoria Wojciechowska, Marek Rajzer, Reinhold Kreutz, Thomas Weber, Michael Bursztyn, Alexandre Persu, George Stergiou, Gianfranco Parati, Grzegorz Bilo, Agnieszka Pac, Guido Grassi, Giuseppe Mancia, Andrzej Januszewicz, Marzena Chrostowska, Krzysztof Narkiewicz, Andżelina Dubiela, Michaelis Doumas, Konstantinos Imprialos, Konstantinos Stavropoulos, Jean-Baptiste de Freminville, Michel Azizi, Pedro Guimarães Cunha, Jacek Lewandowski, Jakub Strzelczyk, Gregoire Wuerzner, Maria Gosk-Przybyłek, Elżbieta Szwench-Pietrasz, Aleksander Prejbisz, Patricia Van der Niepen, Thomas Kahan, Andreas Jekell, Jonas Spaak, Konstantinos Tsioufis, Georg Ehret, Adrian Doroszko, Piotr Kubalski, Jorge Polonia, Katarzyna Styczkiewicz, Marek Styczkiewicz, Stanisław Mazur, Franco Veglio, Franco Rabbia, Elisabetta Eula, Fernando Jaen Águila, Riccardo Sarzani, Francesco Spannella, Zoltan Jarai, Dimitrios Papadopoulos, Marilucy Lopez-Sublet, Aleksandra Ostrowska, Charalampos Grassos, Ioannis Kahrimanidis, Gkaliagkousi Eugenia, Triantafyllou Areti, Grodzicki Tomasz, Wizner Barbara, Seweryn Aleksandra, Moczulska Beata, Ntineri Angeliki, Nicolas Roberto Robles, Jiri Widmiski, Edyta Zbroch","doi":"10.1097/HJH.0000000000003752","DOIUrl":"10.1097/HJH.0000000000003752","url":null,"abstract":"<p><strong>Background: </strong>We aimed to determine the influence of coronavirus disease 2019 (COVID-19) pandemic on blood pressure (BP) control assessed by ambulatory blood pressure monitoring (ABPM).</p><p><strong>Methods: </strong>Office BP and ABPM data from two visits conducted within a 9-15 months interval were collected from patients treated for hypertension. In the prepandemic group, both visits took place before, while in the pandemic group, Visit-1 was done before and Visit-2 during the pandemic period.</p><p><strong>Results: </strong>Of 1811 collected patients 191 were excluded because they did not meet the required ABPM time frames. Thus, the study comprised 704 patients from the pandemic and 916 from the prepandemic group. Groups did not differ in sex, age, duration of hypertension, frequency of first line antihypertensive drug use and mean 24 h BP on Visit-1. The prevalence of sustained uncontrolled hypertension was similar in both groups. On Visit-2 mean 24 h BP, daytime and nighttime systolic BP and diastolic BP were higher in the pandemic compared to the prepandemic group ( P  < 0.034). The prevalence of sustained uncontrolled hypertension on Visit-2 was higher in the pandemic than in the prepandemic group [0.29 (95% confidence interval (95% CI): 0.26-0.33) vs. 0.25 (95% CI: 0.22-0.28), P  < 0.037]. In multivariable adjusted analyses a significant difference in BP visit-to-visit change was observed, with a more profound decline in BP between visits in the prepandemic group.</p><p><strong>Conclusions: </strong>This study using ABPM indicates a negative impact of the COVID-19 pandemic on BP control. It emphasizes the need of developing strategies to maintain BP control during a pandemic such as the one induced by COVID-19.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"2065-2074"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154342","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":"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":"https://doi.org/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":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-28","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":"Racial and regional disparities in the risk of noncommunicable disease between sub-Saharan black and European white patients.","authors":"Yu-Ling Yu, De-Wei An, Babangida S Chori, Błażej P Kaleta, Gontse Mokwatsi, Dries S Martens, Olugbenga O Abiodun, Tina Anya, Agnieszka Łebek-Szatańska, Jong-Shiuan Yeh, Catharina M C Mels, Agnieszka Latosinska, Ruan Kruger, Godsent Isiguzo, Krzystof Narkiewicz, Muhammad N Shehu, Martin Salazar, Walter Espeche, Blerim Mujaj, Jana Brgulian-Hitij, Agnieszka Olszanecka, Wiktoria Wojciechowska, Peter Reyskens, Marek Rajzer, Andrzej Januszewicz, Katarzyna Stolarz-Skrzypek, Kei Asayama, Karel Allegaert, Peter Verhamme, Harald Mischak, Tim S Nawrot, Augustine N Odili, Jan A Staessen","doi":"10.1097/HJH.0000000000003930","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003930","url":null,"abstract":"<p><strong>Objectives: </strong>Greater vulnerability of Black vs. White individuals to cardiovascular disease (CVD) and chronic kidney disease (CKD) is well charted in the United States, but studies involving sub-Saharan blacks are scarce.</p><p><strong>Methods: </strong>Baseline data (2021-2024) were collected in 168 sub-Saharan Blacks and 93 European Whites in an ongoing clinical trial (NCT04299529), using standardized patient selection criteria. Data included clinical and biochemical risk factors, ECG and echocardiographic traits, Framingham CVD risk, CKD grades (KDIGO 2024), self-assessed symptoms (WHO questionnaire), and urinary proteomic profiles predictive of left ventricular dysfunction (LVD) and CKD, HF1, and CKD273, respectively. Racial comparisons rested on unadjusted and multivariable-adjusted analyses.</p><p><strong>Results: </strong>Despite being younger (60.4 vs. 68.3 years), blacks had a worse risk profile, as evidenced by higher diabetes prevalence, higher BMI, faster heart rate, unfavourable serum cholesterol fractions, lower estimated glomerular filtration rate, microalbuminuria, and sedentary lifestyle. This resulted in blacks having higher 10-year CVD risk, higher heart age (index of vascular ageing with chronological age as reference), and a worse CKD grades. In both races, CKD273 increased with CKD grade, but CKD273 and HF1 were not different by race. These observations were robust in subgroup and adjusted analyses.</p><p><strong>Conclusion: </strong>This study did not differentiate host (genetic, molecular, and pathogenic) from environmental drivers of disease. Nonetheless, the findings call for a multipronged and comprehensive implementation of innovative health policies in sub-Saharan countries. Education, research, empowerment of stakeholders, and international learned societies connecting experts from a wide array of disciplines should vigorously sustain this effort.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801084","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":"Relationship between blood pressure variability and blood pressure phenotypes: a home blood pressure monitoring study.","authors":"Marco A M Alves, Rodrigo Bezerra, Christian S Dal Pont, Marco A Mota-Gomes, Annelise M G Paiva, Weimar S Barroso, Roberto D Miranda, Eduardo C D Barbosa, Andréa A Brandão, José L Lima-Filho, Antonio Coca, Andrei C Sposito, Audes D M Feitosa, Wilson Nadruz","doi":"10.1097/HJH.0000000000003925","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003925","url":null,"abstract":"<p><strong>Objective: </strong>Home blood pressure (BP) variability (BPV) and BP phenotypes such as white-coat hypertension (WCH), white-coat uncontrolled hypertension (WUCH), masked hypertension (MH) and masked uncontrolled hypertension (MUCH) are predictors of adverse cardiovascular events. This study compared home BPV across BP phenotypes built from abnormal office BP (OBP) and home BP monitoring (HBPM) thresholds defined by three distinct societies [European Society of Hypertension (ESH): OBP ≥ 140/90 mmHg and HBPM ≥ 135/85 mmHg; American College of Cardiology/American Heart Association (ACC/AHA): OBP and HBPM ≥ 130/80 mmHg and Brazilian Society of Cardiology (BSC): OBP ≥ 140/90 mmHg and HBPM ≥ 130/80 mmHg].</p><p><strong>Methods: </strong>This cross-sectional study evaluated 51 194 treated (37% men, age = 61 ± 15 years) and 56 100 untreated (41% men, age = 54 ± 16 years) individuals from 1045 Brazilian centers who underwent OBP and HBPM measurements. Systolic and diastolic home BPV were estimated as the: standard deviation, coefficient of variation, and the variability independent of the mean of HBPM.</p><p><strong>Results: </strong>Results of adjusted analysis showed that home BPV parameters were significantly greater in individuals with WCH/WUCH according to the BSC criteria, in those with MH/MUCH defined by the ACC/AHA criteria, and tended to be greater in individuals with either MH/MUCH or WCH/WUCH defined by the ESH criteria.Furthermore, restricted cubic spline analysis showed a U-shaped association between BPV and the difference between OBP and HBPM in treated and untreated individuals.</p><p><strong>Conclusion: </strong>Home BPV was greater in WCH/WUCH and/or MH/MUCH depending on the criteria used to define abnormal OBP and HBPM thresholds. These findings underscore the need to standardize abnormal BP criteria in clinical practice.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621955","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":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/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":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between PM 2.5 and its chemical constituents and blood pressure: a cross-sectional study.","authors":"Shu Dong, Bin Yu, Chun Yin, Yuchen Li, Wenling Zhong, Chuanteng Feng, Xi Lin, Xu Qiao, Yanrong Yin, Zihang Wang, Tiehui Chen, Hongyun Liu, Peng Jia, Xiaoqing Li, Shujuan Yang","doi":"10.1097/HJH.0000000000003795","DOIUrl":"10.1097/HJH.0000000000003795","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the associations between PM 2.5 and its chemical constituents with blood pressure (BP), assess effects across BP quantiles, and identify the key constituent elevating BP.</p><p><strong>Methods: </strong>A total of 36 792 adults were included in the cross-sectional study, representing 25 districts/counties of southeast China. Quantile regression models were applied to estimate the associations of PM 2.5 and its chemical constituents (ammonium [NH 4+ ], nitrate [NO 3- ], sulfate [SO 42- ], black carbon [BC], organic matter [OM]) with systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean artery pressure (MAP). A weighted quantile sum (WQS) index was used to estimate the relative importance of each PM 2.5 chemical constituent to the joint effect on BP.</p><p><strong>Results: </strong>The adverse effects of each interquartile range (IQR) increase in PM 2.5 , NH 4+ , NO 3- , SO 42- , and BC on BP were found to be greater with elevated BP, especially when SBP exceeded 133 mmHg and DBP exceeded 82 mmHg. Each IQR increase in all five PM 2.5 chemical constituents was associated with elevated SBP ( β [95% CI]: 0.90 [0.75, 1.05]), DBP ( β : 0.44 [0.34, 0.53]), and MAP ( β : 0.57 [0.45, 0.69]), NH 4+ (for SBP: weight = 99.43%; for DBP: 12.78%; for MAP: 60.73%) and BC (for DBP: 87.06%; for MAP: 39.07%) predominantly influencing these effects. The joint effect of PM 2.5 chemical constituents on risks for elevated SBP and DBP exhibited an upward trend from the 70 th quantile (SBP exceeded 133 mmHg, DBP exceeded 82 mmHg).</p><p><strong>Conclusion: </strong>Long-term exposure to PM 2.5 and its chemical constituents was associated with increased risk for elevated BP, with NH 4+ and BC being the main contributors, and such associations were significantly stronger at 70th to 90th quantiles (SBP exceeded 133 mmHg, DBP exceeded 82 mmHg).</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1897-1905"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154325","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":"Barriers and facilitators to home blood pressure monitoring in women with pregnancies complicated by hypertensive disorders: a qualitative study.","authors":"Lara C Kovell, Mawulorm Denu, Ritika Revoori, Katherine Sadaniantz, Brooke Staples, Germán Chiriboga, Sarah N Forrester, Stephenie C Lemon, Tiffany A Moore Simas, Sharina Person, David D McManus, Kathleen M Mazor","doi":"10.1097/HJH.0000000000003835","DOIUrl":"10.1097/HJH.0000000000003835","url":null,"abstract":"<p><strong>Background/objective: </strong>Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality in the US. Improved diagnosis and treatment of HDP may be achieved through home blood pressure monitoring (HBPM). However, there are challenges to effective HBPM during pregnancy. This qualitative study was conducted to explore patients' perspectives and experiences with HBPM.</p><p><strong>Methods: </strong>Pregnant or recently postpartum women with HDP (≥18 years) were recruited from an academic medical center to virtual focus groups from March to September 2023. The discussions centered on experiences with HDP and barriers and facilitators to HBPM. Qualitative thematic analysis was performed.</p><p><strong>Results: </strong>Among 20 participants, the mean age was 33.8 (SD 5.9) years, with 35% Hispanic and 35% Black/African-American. Facilitators to HBPM included understanding the parameters/purpose of HBPM, prior experience with healthcare/duration of hypertension, free access to HBPM equipment and decision support, creating a routine, external support/counseling (e.g., partner/healthcare/family), and technology support. Barriers to HBPM included uncertainty/lack of training about the HBPM process, accessing/using HBPM equipment, the belief that clinic monitoring was sufficient/achieving good control, and activation barriers to making HBPM a priority (e.g., fear of affirming the diagnosis, higher priorities/life stressors).</p><p><strong>Conclusion: </strong>Many of the barriers to HBPM in pregnancy can be overcome through patient education/counseling, technology support, clinician/family reinforcement, and better access to validated blood pressure monitors. Given the importance of HBPM in improving outcomes for HDP, it is important for healthcare providers and policy makers to work to reduce barriers and amplify facilitators to HBPM for better adoption.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1994-2002"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154327","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":"Formula-led methods using first morning fasting spot urine to assess usual salt intake: a secondary analysis of PURE study data.","authors":"Rachael M McLean, Jing Song, Changqiong Wang, Feng J He, Francesco P Cappuccio, Norm Rc Campbell, Graham A MacGregor","doi":"10.1097/HJH.0000000000003831","DOIUrl":"10.1097/HJH.0000000000003831","url":null,"abstract":"<p><strong>Objectives: </strong>Observational studies that assess the relationship between salt intake and long-term outcomes require a valid estimate of usual salt intake. The gold-standard measure in individuals is sodium excretion in multiple nonconsecutive 24-h urines. Multiple studies have demonstrated that random spot urine samples are not valid for estimating usual salt intake; however, some researchers believe that fasting morning spot urine samples produce a better measure of usual salt intake than random spot samples.</p><p><strong>Methods: </strong>We have used publicly available data from a PURE China validation study to compare estimates of usual salt intake from morning spot urine samples and three published formulae with mean of two 24-h urine samples (reference). We estimated the means and 95% confidence intervals of absolute and relative errors for each formula-led method and the degree to which estimates were able to be classified into the correct quartile of intake. Bland-Altman plots were used to test the level of agreement.</p><p><strong>Results: </strong>The results show that compared with the reference method, all formulae-led estimates from spot urine collections have high error rates: both random and systematic. This is demonstrated for individual estimates, as well as by quartiles of reference salt intake. This study conclusively demonstrates the unsuitability of morning spot urine formula-led estimates of usual salt intake.</p><p><strong>Conclusion: </strong>Our findings support international recommendations to not conduct, fund, or publish research studies that use spot urine samples with estimating equations to assess individuals' salt intake in association with health outcomes.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"2003-2010"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154332","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":"Renal adaptation in pre-obesity patients with hypertension.","authors":"Agnes Bosch, Manfred Rauh, Kristina Striepe, Mario Schiffer, Roland E Schmieder, Dennis Kannenkeril","doi":"10.1097/HJH.0000000000003821","DOIUrl":"10.1097/HJH.0000000000003821","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Obesity aggravates the risk to develop chronic kidney disease in hypertensive patients. Whether pre-obesity already impairs renal function, renal perfusion and intraglomerular hemodynamics in hypertensive patients is unknown.</p><p><strong>Methods: </strong>Renal hemodynamic profiles were measured using steady state input clearance (infusion of para-amino-hippuric acid and inulin) in 36 patients with primary arterial hypertension stage 1-2 without antihypertensive medication. Intraglomerular pressure (IGP) and resistances of the afferent (RA) and efferent (RE) arterioles were calculated. The study population was divided into two groups based on median of waist circumference (WC) (96 cm) (pre-obesity and non-obesity group1) and median of body mass index (BMI) (26.5 kg/m 2 ) (pre-obesity and non-obesity group2), respectively.</p><p><strong>Results: </strong>All patients were males, non-smoking, aged 36 ± 10 years, with an office blood pressure of 145 ± 8.6/89 ± 11.8 mmHg. None of the patients had cardiovascular disease. Patients from the pre-obese group 1 showed lower glomerular filtration rate (GFR), lower renal plasma flow (RPF) and lower IGP compared to the non-obese group1. Renal vascular resistance (RVR) and RA were higher in the pre-obese group1 compared to the non-obese group1. Similar differences in the hemodynamic profile were found for patients in the pre-obesity group2 compared to the non-obesity group2.</p><p><strong>Conclusion: </strong>The renal hemodynamic profile in hypertensive patients with pre-obesity, irrespective whether defined by WC or BMI, was characterized by a reduced GFR and RPF and by an increased RVR preferentially at the preglomerular site. Our results suggest that hypofiltration is the first phase of renal adaptation in pre-obesity hypertension.</p><p><strong>Clinical trial registration: </strong>www.clinicaltrials.gov : NCT02783456.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1958-1965"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154339","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}