Journal of Hypertension最新文献

{"title":"Does hypercholesterolemia worsen cognitive decline in arterial hypertension? Insights from clinical and experimental studies.","authors":"Andressa Betat, Viviane Dos Santos, Cláudio Gabriel Aguiar de Oliveira, Lais Alflen, Charles Francisco Ferreira, Geison Souza Izídio, Renata Maria Lataro","doi":"10.1097/HJH.0000000000004277","DOIUrl":"10.1097/HJH.0000000000004277","url":null,"abstract":"<p><strong>Background: </strong>Arterial hypertension has been linked to cognitive decline, potentially through cerebrovascular alterations and associations with Alzheimer's disease. A positive correlation between elevated serum cholesterol levels and cognitive impairment has been observed. However, the impact of hypercholesterolemia on cognitive decline in both hypertensive rats and patients remains unclear. This study aimed to test the hypothesis that hypercholesterolemia exacerbates cognitive decline in hypertensive rats and human patients.</p><p><strong>Methods: </strong>Spontaneously hypertensive rats (SHR) with diet-induced hypercholesterolemia underwent behavioral testing to assess recognition, spatial, and working memory. In patients with stage 2 hypertension, cognitive function was assessed using the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) instruments.</p><p><strong>Results: </strong>In SHRs, hypercholesterolemia did not alter cognitive performance. Treatment of SHR with amlodipine or captopril decreased arterial pressure; however, this reduction did not improve cognition performance. The MMSE and MoCA, respectively, revealed cognitive impairment in 87.1 and 97.6% of the hypertensive patients. Nevertheless, no significant differences were found in the mean scores between hypertensive patients with and without hypercholesterolemia. No significant correlation was observed between cognitive scores and the use of antihypertensive or lipid-lowering agents.</p><p><strong>Conclusion: </strong>These observations provide evidence that hypercholesterolemia does not exacerbate cognitive impairment in hypertension. Furthermore, our current findings support the hypothesis that antihypertensive treatment, in the absence of strict blood pressure control, may be insufficient to prevent hypertension-related cognitive decline.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"980-991"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512596","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":"Beyond the valve: long-term blood pressure trajectories and their prognostic significance following transcatheter aortic valve implantation.","authors":"Wenhui Li, Kully Sandhu, Gregory Y H Lip","doi":"10.1097/HJH.0000000000004282","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004282","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 6","pages":"952-954"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773612","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":"Patient-profiled treatment responses in a large hypertension trial: a posthoc analysis of the INSIGHT study.","authors":"Peter W De Leeuw, Giuseppe Mancia, Chris R Palmer, Luis M Ruilope, Solko W Schalm, Morris J Brown","doi":"10.1097/HJH.0000000000004284","DOIUrl":"10.1097/HJH.0000000000004284","url":null,"abstract":"<p><strong>Objective: </strong>Guidelines on the treatment of hypertensive patients usually refer to 'average' patients. However, in clinical practice, individual patient characteristics may differ substantially from the average. Thus, it seems worthwhile to examine the relationship between comprehensive patient profiles and blood pressure responses.</p><p><strong>Methods: </strong>We divided the patient population from the INSIGHT trial into exploration and validation cohorts and constructed composite patient profiles based on predictors of blood pressure control (age, severity of hypertension, comorbidities, and previous treatment status). Next, we tested in the exploration cohort whether blood pressure control rates and adverse effects after 6 months of therapy across these profiles differed from those in the entire patient group. Finally, we explored whether the results from the exploration cohort could be validated using another cohort.</p><p><strong>Results: </strong>Logistic regression analysis showed that the odds of achieving blood pressure control differed substantially between patient profiles but not between treatment modalities. Patients with a less favorable profile (e.g. the combination of age above 60 years, baseline systolic pressure above 160 mmHg, and the presence of diabetes) did less well than patients with a low-risk profile (e.g. absence of organ damage). These results were confirmed in the validation cohort.</p><p><strong>Conclusion: </strong>We conclude that responses to antihypertensive treatment vary in a clinically important manner depending on the composite patient profiles. When found in other trials as well, a priori knowledge about response rates of various patient-profile treatment regimens may help choose the best treatment in individual patients and improve overall blood pressure control rates.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"999-1004"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485799","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":"Treating obesity and heart failure: a how-to-manage guide from the European Association for the Study of Obesity and the European Society of Hypertension working group on diabetes and metabolic risk factors.","authors":"Christina Antza, Jens Jordan, Barbara McGowan, Andreea Ciudin, Francesca Filippi-Arriaga, Jan-Niklas Hoenemann, Anna Jelacovic, Peter Nilsson, Konstantinos Tsioufis, Wolfram Doehner, Vasilios Kotsis, Volkan Yumuk","doi":"10.1097/HJH.0000000000004285","DOIUrl":"10.1097/HJH.0000000000004285","url":null,"abstract":"<p><p>Obesity is a key contributor to heart failure, driving increased morbidity, mortality, and healthcare costs. This association is supported by multiple pathophysiological mechanisms and consistent epidemiological evidence, particularly not only in heart failure with preserved ejection fraction (HFpEF), but also in heart failure with reduced ejection fraction (HFrEF). Given the rising prevalence of both diseases, integrated management strategies are essential. This review outlines current management options in patients with heart failure and obesity, from lifestyle modification to pharmacological and surgical treatment, and explores emerging treatments aimed at mitigating this growing burden.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"938-947"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443785","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":"Contribution of hypertension to recent changes in cardiovascular disease mortality: a population-based study in the United States.","authors":"Cande V Ananth, Jessica C Fields, Rachel Lee, Katherine M Keyes, William J Kostis","doi":"10.1097/HJH.0000000000004298","DOIUrl":"10.1097/HJH.0000000000004298","url":null,"abstract":"<p><strong>Objectives: </strong>Hypertension remains a persistent global challenge and is an essential risk factor for cardiovascular disease (CVD). However, the extent to which hypertension is implicated in CVD mortality in the United States remains unknown. We assessed CVD mortality trends with hypertension as a secondary cause (CVD-HTN) and the proportion of CVD mortality in those with and without secondary hypertension.</p><p><strong>Methods: </strong>We designed a sequential time-series analysis to examine trends in age-standardized mortality rates (18-84 years) with CVD as the underlying cause, with and without concomitant hypertension (as a secondary cause), in the United States from 2000 to 2022. We examined changes in CVD-HTN mortality rates (per 100 000 individuals). We assessed the proportionate fraction of CVD mortality in patients with and without hypertension as a secondary cause.</p><p><strong>Results: </strong>Among females, CVD-HTN mortality rates have increased from 47.4 in 2000 to 52.4 per 100 000 in 2022. CVD mortality rates without concomitant hypertension among females declined from 189.9 in 2000 to 98.0 per 100 000 in 2022. CVD-HTN mortality rates among males increased from 67.3 in 2000 to 96.2 per 100 000 in 2022. CVD mortality rates without concomitant hypertension among males declined over the same period (339.4 in 2000 to 169.9 per 100 000 in 2022). Among females in 2000 and 2022, 20 and 34.8% of CVD deaths were due to concomitant hypertension; among males, these estimates were 16.5 and 36.2%, respectively.</p><p><strong>Conclusion: </strong>The increase in CVD mortality associated with concomitant hypertension is concerning. Public health efforts to mitigate this increase may be worth considering.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1041-1049"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512575","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":"Methodological approaches to the assessment of blood pressure variability in patients on hemodialysis.","authors":"Panagiotis I Georgianos, Eirini Leptokaridou-Mourtzila, Athanasios Roumeliotis, Vassilios Liakopoulos","doi":"10.1097/HJH.0000000000004288","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004288","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 6","pages":"1076-1077"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773599","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":"Unmasking genetic predictors of myocardial infarction in arterial hypertension treated with angiotensin receptor blockers via interpretable artificial intelligence.","authors":"Eleni Manta, Christos Fragoulis, Konstantinos Tsioufis","doi":"10.1097/HJH.0000000000004310","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004310","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 6","pages":"957-958"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773571","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":"Progression of exaggerated blood pressure variability in annual 24-h ambulatory blood pressure monitoring associated with autonomic dysfunction: a pathological case report.","authors":"Joji Ishikawa, Yuko Saito, Ayumi Toba, Kaoruko Fukushima, Takashi Takei, Satoru Morimoto, Atsushi Iwata, Manato Hara, Shigeo Murayama, Tomio Arai, Kazumasa Harada","doi":"10.1097/HJH.0000000000004287","DOIUrl":"10.1097/HJH.0000000000004287","url":null,"abstract":"<p><p>This study describes the case of an 83-year-old man with long-standing hypertension, urinary dysfunction, and constipation. Annual 24-h ambulatory blood pressure monitoring revealed increased blood pressure variability and reduced nocturnal dipping. One year earlier, exaggerated blood pressure fluctuations and postprandial hypotension had emerged, which persisted despite the reduced use of antihypertensive medication. The tests confirmed orthostatic and postprandial hypotension and low heart rate variability, indicating autonomic dysfunction. Cognitive function was preserved and the patient's physical function remained intact. Imaging findings suggested prodromal dementia with Lewy bodies, although the typical symptoms of this disease were absent. Blood pressure control became difficult and  stabilized after development of chronic renal failure. The patient died of colon cancer and renal failure. An autopsy revealed widespread α-synuclein in the peripheral nerves and cardiac autonomic degeneration, with mild loss of neurons in the substantia nigra but severe degeneration in the locus coeruleus. Lewy body pathology slowly spreads to the hippocampus and neocortex. These findings demonstrated that exaggerated BP variability in ambulatory blood pressure monitoring could be early marker of the progression of autonomic dysfunction, caused by prodromal body-first-type of α-synucleinopathy, before appearance of neurological symptoms.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1062-1067"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443851","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 and influencing factors of masked uncontrolled hypertension among Chinese female patients with clinically controlled hypertension.","authors":"Qian Liu, Nanfang Li, Qinghua Han, Yuanyuan Chen, Ningling Sun, Shouling Wu, Jing Yu","doi":"10.1097/HJH.0000000000004296","DOIUrl":"10.1097/HJH.0000000000004296","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Hypertension is a leading modifiable risk factor for cardiovascular disease (CVD) and mortality. The high risk of CVD and mortality observed in patients with controlled office blood pressure may be associated with masked uncontrolled hypertension (MUCH). Previous studies have shown that females with hypertension tend to have lower rates of blood pressure control than males. However, data on blood pressure control during daily life among female patients with treated hypertension are limited, and the prevalence of MUCH among those with clinically controlled hypertension remains unclear. Therefore, we aimed to investigate the prevalence, distribution, and influencing factors of MUCH among female patients with clinically controlled hypertension using a large, nationally representative survey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed data from the Chinese Cardiovascular Association Database-Hypertension Center collected between January 1, 2019 and December 31, 2023. Office blood pressure control was defined as &lt;140/90 mmHg in patients with treated hypertension, in accordance with existing guidelines. In this population, MUCH was diagnosed as an average 24-h blood pressure ≥130/80 mmHg. Female patients with clinically controlled hypertension who completed 24-h ambulatory blood pressure monitoring (ABPM) were included in the analysis. The prevalence of MUCH was assessed in the overall population and across different groups. We also conducted a multivariable stepwise logistic regression analysis to identify influencing factors of MUCH.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 10 527 female patients with clinically controlled hypertension were included, with an average age of 63.69 years, 5462 (51.89%) of whom were diagnosed with MUCH. The prevalence of MUCH among patients with borderline blood pressure control was 1.62-fold higher than that among those with optimal blood pressure control. Elevated office blood pressure, obesity, mixed dyslipidemia, smoking, and non-Han ethnicity were positively associated with MUCH, whereas higher educational level, hospitalization, menopause status, combination therapy of antihypertensive drugs, and longer duration of hypertension were negatively associated with MUCH. Suboptimal nighttime blood pressure control was the dominant contributor to the high prevalence of MUCH; the proportion of patients with nocturnal MUCH was approximately 12-fold higher than that of patients with exclusively daytime MUCH.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The prevalence of MUCH remains high among female patients with clinically controlled hypertension, with suboptimal nighttime blood pressure control identified as the dominant contributing factor. Patients with obesity, smoking habits, and low education level represent high-risk populations and warrant targeted attention. Our findings suggest that office blood pressure measurements alone may be insufficient to achieve optimal blood pressure co","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1022-1031"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512649","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":"Transvenous microwave aorticorenal ganglion ablation improves renal denervation outcomes.","authors":"Poornima Balaji, Vu Toan Tran, Sadin Afsar, Michael A Barry, Edward Yang, Urja Patel, Xingzhou Liu, Anugrah Nair, Juntang Lu, Duc Minh Nguyen, Shirley Alvarez, Sushil Bandodkar, Winny Varikatt, Alistair McEwan, Stuart P Thomas, Pierre C Qian","doi":"10.1097/HJH.0000000000004271","DOIUrl":"10.1097/HJH.0000000000004271","url":null,"abstract":"<p><strong>Background: </strong>Aorticorenal ganglia (ARG) serve as critical sympathetic relay centers for renal innervation, and their targeted ablation represents a promising alternative to conventional renal artery denervation by enabling precise disruption of renal sympathetic outflow through a transvenous approach.</p><p><strong>Objective: </strong>To test feasibility and efficacy of sympathetic renal denervation (RDN) by targeting ARG using microwave (MW) catheter from inferior vena cava (IVC) in addition to conventional transarterial MW denervation and assess ARG localization in humans using pacing-induced physiological responses.</p><p><strong>Methods: </strong>Pigs underwent sham ( n  = 8), renal denervation (RDN; n  = 7), or RDN plus ARG ablation (RDN + ARG; n  = 7) using custom open-irrigated microwave catheter. Baseline ARG pacing caused renal vasoconstriction and raised mean arterial pressure (MAP). RDN and RDN + ARG groups received one ablation in each main renal artery (100-120 W, 360 s); RDN + ARG also had ARG ablation. After 4-5 weeks, ARG pacing was repeated before euthanasia. In humans ( n  = 3), high-frequency pacing in IVC and renal veins identified ARG capture sites, guided by MRI and electroanatomical mapping.</p><p><strong>Results: </strong>ARG ablation modified pacing responses acutely sustained at 4-5 weeks, with preservation of blood pressure response but significant loss of renal vasoconstriction. Compared to undenervated shams, RDN+ARG vs. RDN reduced viable nerve area by 76% vs. 54% and renal cortical norepinephrine by 51% vs. 15%. In humans, ARG stimulation increased MAP from 108.9 to 123.2 mmHg.</p><p><strong>Conclusions: </strong>ARG ablation, when combined with conventional RDN, achieves greater efferent renal sympathetic denervation in pigs. In humans, analogous sites were identified showing pacing-induced hemodynamic responses consistent with ARG.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"959-969"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512568","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}