Journal of Hypertension最新文献

{"title":"Nighttime blood pressure-targeted antihypertensive treatment.","authors":"Tatsuya Maruhashi, Yoshihiko Kinoshita, Ryoji Ozono, Mitsuaki Nakamaru, Masanori Ninomiya, Jiro Oiwa, Takuji Kawagoe, Osamu Yoshida, Toshiyuki Matsumoto, Yasuo Fukunaga, Kotaro Sumii, Hironori Ueda, Nobuo Shiode, Kosuke Takahari, Yasuhiko Hayashi, Yujiro Ono, Yukiko Nakano, Masakazu Takahashi, Yasuki Kihara, Yukihito Higashi","doi":"10.1097/HJH.0000000000003998","DOIUrl":"10.1097/HJH.0000000000003998","url":null,"abstract":"<p><strong>Objectives: </strong>Nocturnal hypertension is increasingly recognized as a significant risk factor for cardiovascular events. However, there is limited information on whether antihypertensive treatment directly targeting nighttime blood pressure (BP) improves cardiovascular outcomes in medicated patients with hypertension. In this prospective multicenter study, we investigated whether aggressive adjustments in antihypertensive drug treatment targeting nighttime BP can effectively normalize nocturnal hypertension and assessed the safety of this approach.</p><p><strong>Methods: </strong>Nighttime BP was measured using a home BP monitoring device at baseline and at 6 months in 264 medicated patients with hypertension (161 men and 103 women; mean age, 68.5 ± 9.9 years) between October 2015 and March 2019. All patients with nocturnal hypertension, defined as mean nighttime SBP at least 120 mmHg, at baseline received aggressive adjustments in antihypertensive drug treatment targeting nighttime BP. Morning and evening measurements were taken in some patients.</p><p><strong>Results: </strong>Of the 264 patients, 90 had nocturnal hypertension at baseline. After 6 months of medication adjustments, nocturnal hypertension was normalized in 48 (53.3%) of the 90 patients, with values decreasing from 127.8 ± 6.6 to 112.5 ± 6.6 mmHg. Normalization of nocturnal hypertension was accompanied by significant reductions in both morning BP (135.9 ± 12.7 to 126.4 ± 10.8 mmHg, P  < 0.001) and evening BP (130.8 ± 10.9 to 121.9 ± 10.3 mmHg, P  < 0.001). The incidence of nonserious adverse events was higher in patients with nocturnal hypertension, but these events were not deemed specific to the treatment targeting nighttime BP.</p><p><strong>Conclusion: </strong>Aggressive adjustments in antihypertensive drug treatment directly targeting nighttime BP can safely normalize nocturnal hypertension in over half of medicated patients with hypertension within a 6-month period.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"887-896"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624910","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":"Central pulse pressure, carotid artery remodeling and coronary artery calcifications.","authors":"Michaela Kozakova, Carmela Morizzo, Giuli Jamagidze, Sara Chiappino, Dante Chiappino, Michele Emdin, Carlo Palombo","doi":"10.1097/HJH.0000000000003968","DOIUrl":"10.1097/HJH.0000000000003968","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to evaluate the role of central pulse pressure (PP) in carotid wall thickening and coronary artery calcification (CAC).</p><p><strong>Methods: </strong>In an asymptomatic general population ( N  = 396, 163 men, 47-89 years), central PP was measured by applanation tonometry, CAC by computed tomography, and common carotid artery intima-media thickness (cIMT), pulse wave velocity (cPWV) and the power of the signal reflected from carotid media (cMP) by radiofrequency-based carotid ultrasound. High cIMT was defined as cIMT equal to or greater than the 75th percentile for given sex and age, and CAC presence as a CAC score greater than 0.</p><p><strong>Results: </strong>In the entire population, luminal diameter and cMP increased with increasing central PP ( r  = 0.32 and 0.25; P  < 0.0001). One hundred and ninety-seven individuals had high cIMT; individuals with high cIMT had higher central PP, luminal diameter, cMP and cPWV ( P  = or <0.0001), but comparable wall tensile stress ( P  = 0.23). In a logistic regression model, high cIMT was independently associated with luminal diameter and central PP. One hundred and fifty-two individuals had CAC score greater than 0; in a logistic regression model, CAC score greater than 0 was independently associated with sex, age, central PP, LDL-cholesterol, triglycerides and T2DM.</p><p><strong>Conclusion: </strong>Our findings indicate that high central PP contributes both to an increase in cIMT and the development of CAC. However, while central PP was the only risk factor linked to high cIMT, multiple atherosclerotic risk factors were associated with CAC. Therefore, both high cIMT and CAC reflect the adverse impact of high pulsatile load on the vascular system, yet only CAC can be considered a marker of atherosclerosis.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"774-780"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399345","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":"Carotid-femoral pulse wave velocity progression in hypertensive patients is associated with subsequent cardiovascular outcomes.","authors":"Alessandro Maloberti, Paola Rebora, Giuseppe Occhino, Anita Andreano, Rita Cristina Myriam Intravaia, Chiara Tognola, Giorgio Toscani, Gabriele Peraro, Martina Morelli, Magda Rognoni, Luca Cavalieri d'oro, Antonio Russo, Cristina Giannattasio","doi":"10.1097/HJH.0000000000003973","DOIUrl":"10.1097/HJH.0000000000003973","url":null,"abstract":"<p><strong>Objective: </strong>Pulse wave velocity (PWV) is associated with cardiovascular events and mortality. However, little is known on the relationship of its progression (ΔPWV) over time with cardiovascular outcomes. The aim of our study was to evaluate the relationship between ΔPWV and all-cause mortality and cardiovascular events in hypertensive patients.</p><p><strong>Methods: </strong>We enrolled 402 consecutive hypertensive outpatients. At baseline, anamnestic, clinical, blood pressure (BP), laboratory data and PWV were assessed. PWV examination was repeated after 3.8 (I-III quartiles 3.5-4.2) years. Patients were subsequently followed for a median time of 10.1 (I-III quartiles 9.5-10.5) years recording all-cause mortality and cardiovascular events.</p><p><strong>Results: </strong>At baseline, mean age was 53.2 ± 13.0 years, SBP and DBP were 141.8 ± 17.5 and 86.8 ± 10.5 mmHg and PWV was 8.5 ± 1.9 m/s. Despite an improvement in BP control (-9.2 ± 19.5 and -8.0 ± 12.3 for SBP and DBP, respectively), at follow-up, the population showed a PWV increase (ΔPWV +0.6 ± 1.9 m/s). Progressors (ΔPWV ≥0.5 m/s, 204 patients, 50.7%) had a significantly lower survival probability and higher cumulative incidence of composite events, while no differences were seen for cardiovascular events (unadjusted analysis). At Cox multivariable analysis, neither ΔPWV at least 0.5 m/s (progressors) nor ΔPWV (as a spline function) were associated with cardiovascular events and with all-cause mortality. However, the association with survival probability and cumulative incidence of cardiovascular events, as a composite outcome, was significant (hazard ratio = 2.33, 95% CI 1.34-4.05, P  = 0.003).</p><p><strong>Conclusion: </strong>Our study shows that PWV progression at least 0.5 m/s is frequent in hypertensive patients and is associated with a significantly higher risk of developing cardiovascular events or dying (composite outcome).</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"797-806"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624783","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":"Extracellular matrix dynamics in a rat model of pulmonary arterial hypertension: unveiling the role of hyaluronan in disease pathology.","authors":"Pinar Altin Çelik, Metin Aytekin","doi":"10.1097/HJH.0000000000003967","DOIUrl":"10.1097/HJH.0000000000003967","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the feasibility of conducting extracellular matrix studies within this rat model.</p><p><strong>Materials and methods: </strong>This study involved 24 Sprague Dawley rats, divided into two groups. Group 1 served as the normoxia control, while Group 2 is SU-5416 pulmonary arterial hypertension (PAH) model. Pulmonary artery pressure (PAP) was measured in both groups using a micro-catheter Power Lab device. Hyaluronan (HA) plasma level was quantified through ELISA, and HA levels were determined via lung tissue immunostaining. Western blotting detected protein levels, and real-time RT-PCR assessed mRNA expressions for HAS1, HAS2, and HAS3 and hyal1 and hyal2.</p><p><strong>Results: </strong>HA plasma levels were markedly higher in PAH rats compared to controls (HA ng/ml, mean ± SD: PAH 3.8 ± 0.41, control 1.96 ± 0.31, P  < 0.0015). Protein analysis showed no detection of HAS1 and HAS3 proteins in both groups, while HAS2 protein expression was notably higher in PAH rats than controls (HAS2 levels, mean ± SD: PAH 2.0 ± 0.5, control 0.86 ± 0.07, P  = 0.0493). Hyal2 protein expression remained consistent between groups (Hyal2 levels, mean ± SD: PAH 1.41 ± 0.18, control 1.05 ± 0.14, P  = 0.214). No mRNA expression of HAS1, HAS3, and Hyal1 were detected in both groups, Hyal2 expression was identified in both without differences. HAS2 mRNA expression was present in both groups, with a significantly higher increase observed in the hypoxia SU-5416 PAH rat model compared to controls.</p><p><strong>Conclusion: </strong>Establishing an extracellular matrix profile in the rat model, resembling human PAH under hypoxia SU-5416 conditions, highlights the model's suitability for matrix studies.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"768-773"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624941","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":"Cardiovascular effects after five nights without continuous positive airway pressure for obstructive sleep apnea: a randomized controlled trial.","authors":"Carin Sahlin, Magnus Hedström, Martin Claesson, Eva Lindberg, Johan Svensson, Anders Blomberg, Karl A Franklin","doi":"10.1097/HJH.0000000000003990","DOIUrl":"10.1097/HJH.0000000000003990","url":null,"abstract":"<p><strong>Objectives: </strong>Although continuous positive airway pressure (CPAP) effectively prevents sleep apnea and reduces blood pressure, many patients do not use CPAP every night. This trial investigates cardiovascular effects after sleeping five nights without CPAP.</p><p><strong>Methods: </strong>We randomized 100 patients (67 men and 33 women with a mean age 64 ± 9 years) using CPAP treatment for moderate-to-severe sleep apnea to either withdraw treatment for five nights ( n  = 50) or to continue with CPAP ( n  = 50). The primary outcomes were arterial stiffness and 24 h blood pressure.</p><p><strong>Results: </strong>The 24 h SBP increased by a mean of 2.8 mmHg [95% confidence interval (CI) 0.2-5.4 mmHg] ( P  = 0.035) and DBP increased by a mean of 1.7 mmHg (95% CI 0.1-3.3 mmHg) ( P  = 0.032) in the group without CPAP compared to the CPAP group. There was a significant effect on blood pressure in women but not in men. In women, SBP increased by 5.1 mmHg (95% CI 1.0-9.5 mmHg) ( P  = 0.017) and DBP by 2.9 mmHg (95% CI 0.4-5.6 mmHg) ( P  = 0.029). Arterial stiffness remained unaffected. Secondary outcomes that worsened in patients without CPAP included apnea-hypopnea index, oxygen desaturation index, hemoglobin levels, and daytime sleepiness.</p><p><strong>Conclusion: </strong>Blood pressure is affected after five nights of CPAP interruption, along with a rapid return of sleep apneas, nocturnal hypoxic events, daytime sleepiness and increased hemoglobin levels, but arterial stiffness was not affected. Blood pressure was affected in women only, suggesting a sex-related CPAP effect on blood pressure.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"864-870"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657325","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":"Blood pressure phenotypes and day-night variability in acute ischemic stroke: is there any cardiovascular mortality link 10 years after?","authors":"Christina Antza, Vasilios Kotsis","doi":"10.1097/HJH.0000000000003976","DOIUrl":"10.1097/HJH.0000000000003976","url":null,"abstract":"<p><strong>Objective: </strong>Blood pressure (BP) phenotypes and day-night variability have been associated with acute ischemic stroke (AISTR). The aim of this study was to analyze the BP phenotypes and day-night variability during the first 3 days of an AISTR and their correlation with 10-year cardiovascular death (CVD).</p><p><strong>Methods: </strong>Eighty-five volunteers (49.9% men, 77.3 ± 6 years), diagnosed for AISTR, were included in the study. Twenty-four hour ABPM was performed during the first 3 days of AISTR symptoms. A follow-up visit was performed through phone call, 10 years after the AISTR event.</p><p><strong>Results: </strong>There is a reproducible nocturnal circadiac rhythm, with the nondipping status to be the most prevalent (89.3%, 89.2%, 88.3% for Days 1, 2, 3 accordingly, P  > 0.05), compared to dipping status ( P  < 0.05), but not a reproducible BP phenotype, except the hypertensive one (50%, 45.8%, 51.6% for Days 1, 2 and 3 accordingly, P  > 0.05). The mean follow-up was 509.6 ± 10 weeks. 37.1% had died (41.2% from MACE). Cox regression analysis revealed that age [odds ratio (OR):1.15, confidence interval (CI): 1.01-1.17, P  < 0.05], sex (male, OR: 1.92, CI: 1.07-3.82, P  < 0.05), diabetes mellitus (OR: 1.55, CI: 1.06-3.14, P  < 0.05), early vascular ageing (OR: 2.01, CI: 1.19-3.74, P  < 0.05), transient ischemic attack (OR: 2.32, CI: 1.02-5.34, P  < 0.05), sustained hypertension (OR: 2.78, CI: 1.13-6.83, P  < 0.05), day-night SBP ratio (OR: 0.98, CI: 0.96-0.99, P  < 0.05) and day-night DBP ratio (OR: 0.96, CI: 0.94-0.99, P  < 0.05) were significant predictors for CVD.</p><p><strong>Conclusion: </strong>Hence, patients with AISTR present a reproducible nocturnal circadian rhythm, but not a reproducible BP phenotype, except sustained hypertension. These parameters found also to be determinants for 10-year CVD.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"807-813"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399332","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":"Increased arterial stiffness and left ventricular remodelling as markers of masked hypertension: findings from the PAMELA population.","authors":"Cesare Cuspidi, Rita Facchetti, Elisa Gherbesi, Fosca Quarti-Trevano, Jennifer Vanoli, Giuseppe Mancia, Guido Grassi","doi":"10.1097/HJH.0000000000003970","DOIUrl":"10.1097/HJH.0000000000003970","url":null,"abstract":"<p><strong>Background: </strong>The value of the association of arterial stiffness with left ventricular concentric remodelling/left ventricular hypertrophy (LVH) assessed by echocardiography, for prediction of masked hypertension defined by office and ambulatory blood pressure monitoring (ABPM) in the general population is largely undefined. We investigated this topic in the participants to the Pressioni Monitorate E Loro Associazioni (PAMELA) study.</p><p><strong>Methods: </strong>The study included 272 participants (153 normotensives and 119 with masked hypertension) who attended the second and third survey of the PAMELA study performed after 10 and 25 years from the initial evaluation. Data collection included medical history, physical examination, blood tests, office, ABPM, echocardiographic and Cardio-Ankle Vascular Index (CAVI) measurements.</p><p><strong>Results: </strong>Compared to normotensive individuals, participants with masked hypertension were younger, had significantly higher office, home, mean 24-h, day-time, night-time SBP/DBP and heart rate. The likelihood of having masked hypertension, was approximately more than two-fold higher [odds ratio (OR) = 2.29, confidence interval (CI): 1.01-5.31, P  = 0.04] in participants with increased CAVI and left ventricular remodelling/LVH compared to their counterparts without organ damage. This association showed a unique value in identifying masked hypertension compared to both isolated markers of organ damage (OR = 1.69, P  = 0.15 for increased CAVI and OR = 0.82, P  = 0.80 for left ventricular remodelling/LVH), after adjusting for age, sex, office SBP/DBP, antihypertensive treatment and diabetes.</p><p><strong>Conclusion: </strong>The present study offers a new piece of evidence of the key value of looking for both vascular and cardiac organ damage to unmask MH and improve its clinical management in the general population.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"781-789"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399369","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":"Is the heart rate dipping pattern associated with sleep quality during an ambulatory blood pressure monitoring? A cross-sectional study.","authors":"Carlos E Leiva Sisnieguez, Ricardo D Olano, Rodolfo N Stavile, Julián Minetto, Gustavo Cerri, Walter G Espeche, Horacio A Carbajal, Martín R Salazar","doi":"10.1097/HJH.0000000000003971","DOIUrl":"10.1097/HJH.0000000000003971","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to characterize individuals with nondipping heart rate (HR) and to assess the association between that pattern and sleep quality during the night of an ambulatory blood pressure monitoring (ABPM).</p><p><strong>Methods: </strong>Individuals who attended our Unit to perform an ABPM, from February 2022 to May 2024, were asked about clinical and epidemiological antecedents and responded two validated surveys, about sleep quality during the night of the ABPM and in the prior 30 days. Then, they were categorized according to the presence of a dipping in nocturnal HR (defined as a decline in average HR at night equal or higher than 10% compared with daytime values) as HR dippers or HR nondippers (drop in mean nighttime HR lower than 10% of diurnal mean) in order to compare the mentioned variables.</p><p><strong>Results: </strong>One thousand two hundred and nine individuals were included. They were predominantly female (61.8%), middle-aged (median 50 years, IQR 36-60), overweight (median BMI 29, IQR 25.3-33.5) and had median ABPM estimates within normal ranges. In individuals without beta-blockers ( n  = 1107), HR nondippers had an adverse cardiovascular disease (CVD) risk profile, and no differences were found between HR dippers and HR nondippers concerning perceived good rest during the ABPM night (63.5 vs. 59.7%, P  = 0.211) and usual sleep quality. The sensitivity analysis including beta-blockers' users ( n  = 102) was consistent.</p><p><strong>Conclusion: </strong>A blunted dipping in mean nighttime HR identifies individuals with a high CVD risk profile and is not associated with bad sleep quality during the night of an ABPM.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"790-796"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399401","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":"Chronic hypertension in pregnancy: insights into adverse outcomes prevention.","authors":"Rossana Orabona, Rossella Monaci, Sara Branca, Silvia Sartorello, Chiara Tomasoni, Anna Fichera, Francesca Ramazzotto, Adriana Valcamonico, Sonia Zatti, Franco E Odicino","doi":"10.1097/HJH.0000000000003978","DOIUrl":"10.1097/HJH.0000000000003978","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the role of low molecular weight heparin in the prevention of preeclampsia and/or fetal growth restriction in pregnant women with chronic hypertension.</p><p><strong>Methods: </strong>Women diagnosed with chronic hypertension were retrospectively selected from our electronic database from January 2019 to January 2024. The primary endpoint was the occurrence of adverse pregnancy outcomes described as the onset of preeclampsia and/or fetal growth restriction.</p><p><strong>Results: </strong>A total of 219 pregnant women with chronic hypertension were included. BMI before pregnancy was 27.8 ± 6.4 kg/m 2 and age 36.1 ± 5.4 years. Preeclampsia and fetal growth restriction occurred in 22.9 and 9.6% of patients, respectively. As concerns prophylaxis in the first trimester, 80.1% of patients were administered low-dose aspirin (100 mg), while 16.7% low molecular weight heparin (at prophylactic doses according to BMI), of which 86.1% aspirin + heparin. The rate of preeclampsia was similar in patients taking aspirin or not (21.3 vs. 25%), while it significantly differed in those administered with heparin as thromboprophylaxis (8.8 vs. 25%, P  = 0.04). Fetal growth restriction occurrence did not differ according to the use of prophylaxis. High resistance at uterine arteries Doppler velocimetry at 24-25 weeks of gestation was confirmed to be associated with the onset of preeclampsia (51 vs. 11.9%; P  < 0.001) and fetal growth restriction (18.2 vs. 6.9%; P  = 0.04).</p><p><strong>Conclusion: </strong>Thromboprophylaxis with low molecular weight heparin reduces the onset of superimposed preeclampsia, independently from aspirin intake.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"822-826"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624936","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":"Decreased adenosine 3',5'-cyclic monophosphate is a driving factor of P300/SIRT1-mediated histone hyperacetylation in obesity-related hypertension.","authors":"Yuting Wang, Qin Zhang, Chen Shen, Hui Wang, Yaqi Li, Haojie Wu, Xiaodong Sun, Lin Shi","doi":"10.1097/HJH.0000000000003981","DOIUrl":"10.1097/HJH.0000000000003981","url":null,"abstract":"<p><strong>Background: </strong>Obesity is the most significant risk factor associated with primary hypertension. A high-fat diet may lead to obesity-related hypertension, with evidence indicating that individuals with this condition exhibit a diminished adenosine 3',5'-cyclic monophosphate (cAMP) signaling pathway, although the exact mechanisms remain unclear. This study aimed to investigate the regulatory role of the cAMP signaling pathway in obesity-related hypertension.</p><p><strong>Methods: </strong>A rat model of obesity-related hypertension was established by feeding with a high-fat diet for 16 weeks. Changes in the cAMP signaling pathway and SIRT1 in rat renal tissues were explored using immunohistochemistry, immunofluorescence, and RT-qPCR. The effects and mechanisms of the cAMP signaling pathway on histone 3 lysine 27 acetylation and ACE1 were investigated by intervening in human renal tubular epithelial cells with P300, cAMP activators, SIRT1, cAMP inhibitors, and oleic acid.</p><p><strong>Results: </strong>The cAMP signaling pathway was found to be suppressed in rat renal tissue after feeding a high-fat diet, and a simultaneous decrease in histone deacetylase was observed. Furthermore, we identified that the inhibition of cAMP leads to the reduction of SIRT1 and the induction of P300. In addition, vitro experiments suggested that oleic acid suppressed the cAMP signaling pathway, which subsequently upregulated histone 3 lysine 27 acetylation and angiotensin converting enzyme 1 (ACE1) by increasing the expression of P300 and decreasing the expression of SIRT1.</p><p><strong>Conclusion: </strong>The reduced cAMP signaling pathway in obesity could promote histone 3 lysine 27 acetylation modification and upregulate ACE1 expression by regulating P300 and SIRT1 levels, which may have important implications in the management of obesity-related hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"841-851"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624938","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}