Journal of Hypertension最新文献

{"title":"Deciphering the 'superiority' of recovery-estimated pulse wave velocity.","authors":"Qingquan Wu, Guoqiu Pang","doi":"10.1097/HJH.0000000000004262","DOIUrl":"10.1097/HJH.0000000000004262","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 10","pages":"1896"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818556","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":"A modified model of cardiac reverse remodeling following abdominal aortic banding and debanding in rats.","authors":"Shukun He, Yanting Zhang, Jiawei Shi, Jingrong Jiang, Tianshu Liu, Wenhui Deng, Wenqu Li, Ying Bai, Jiani Qiu, Yingxin Li, Qiaofeng Jin, Phil Chowienczyk, Li Zhang, Mingxing Xie, Haotian Gu, Jing Wang","doi":"10.1097/HJH.0000000000004393","DOIUrl":"10.1097/HJH.0000000000004393","url":null,"abstract":"<p><strong>Objective: </strong>Cardiac reverse remodeling (RR) after pressure unloading has been widely studied using abdominal aortic banding (AB) and debanding (DB) models. However, the DB procedure is technically challenging and associated with high postoperative mortality, limiting broader use. Here, we aim to develop a modified, film-supported ligature technique for AB and DB to improve procedural feasibility and survival and to generate a reproducible RR model.</p><p><strong>Methods: </strong>A rat cardiac RR model was established using medical film-supported abdominal AB followed by DB. Rats underwent 4  weeks of AB and then 2  weeks of DB. Echocardiography and blood pressure measurement were performed to confirm successful establishment of pressure overload and subsequent unloading. RR was assessed by echocardiographic structural and functional parameters, cardiac histology and serum levels of BNP, ANP and GDF-15.</p><p><strong>Results: </strong>The modified DB procedure yielded a postoperative survival rate of 93.33%. AB induced significant hemodynamic changes at the constriction site and led to progressive cardiac remodeling and diastolic dysfunction from 4 to 6  weeks. After 2  weeks of DB, cardiac function showed substantial improvement; serum BNP, ANP and GDF-15 levels, as well as cardiac hypertrophy and fibrosis returned close to baseline.</p><p><strong>Conclusion: </strong>The film-supported AB and DB model is a technically streamlined and reproducible rat approach that markedly reduces postoperative mortality and enables consistent induction and reversal of cardiac remodeling. This model provides a useful experimental platform for studies of RR.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 10","pages":"1799-1811"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818425","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":"2026 ISH guidelines for the management of hypertension in Africa: the International Society of Hypertension (ISH) African Regional Advisory Group and the Pan African Society of Cardiology (PASCAR).","authors":"Alfred Doku, Ruan Kruger, Kofi T Asamoah, Florence K Akumiah, Tangeni Auala, Hind Beheiry, Reuben Mutagaywa, Godsent Isiguzo, Adeseye A Akintunde, Anastase Dzudie, James B W Russell, Elvine P Nguelefack-Mbuyo, Manmak H Mamven, Maureen U Amaechi, Samah S Elfadil, Aileen Barongo, Gudila Shirima, Toure A Ibrahim, Dike Ojji, Albertino Damasceno, Augustine Odili, Elijah Ogola, Nadia Khan, Aletta E Schutte, Tazeen H Jafar, Bryan Williams, Erika S W Jones, George S Stergiou","doi":"10.1097/HJH.0000000000004411","DOIUrl":"10.1097/HJH.0000000000004411","url":null,"abstract":"<p><p>Hypertension in sub-Saharan Africa is escalating, with many cases undiagnosed and poorly controlled, even among children, despite its significant contribution to cardiovascular disease. Poor blood pressure control is largely due to limited national guidelines, underfunded programs, and a shortage of trained health professionals. Simplified protocols for non-physician health workers, who deliver most of the primary care, are essential. Cultural myths and misconceptions further delay care, underscoring the need for community-based education. Early and opportunistic screening, including in schools, markets, and places of worship, is vital across the life course. Sustainable progress depends on tailored strategies, investment in equipment and training, and leveraging existing infrastructure to improve hypertension detection and management. Africa-centred hypertension guidelines are now a priority because international models fail to address the continent's unique clinical, cultural and resource realities. The African Regional Advisory Group of the International Society of Hypertension worked with the Pan African Society of Cardiology to develop simplified protocols for primary care, particularly for non-physician health care workers, by considering the special situation and condition for managing the vast majority of cases within hypertension in Africa.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1732-1760"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673791","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":"All eyes on gas exchange: impact of controlled arterial hypertension on cardiopulmonary function and the effects of high-intensity interval training.","authors":"Fabian Schwendinger, Jonathan Wagner, Christoph Hauser, Eva Fleischlin, Justin Carrard, Arno Schmidt-Trucksäss, Henner Hanssen, Lukas Streese","doi":"10.1097/HJH.0000000000004394","DOIUrl":"10.1097/HJH.0000000000004394","url":null,"abstract":"<p><strong>Introduction: </strong>Arterial hypertension (AH) impairs vascular function which, in turn, may reduce cardiopulmonary function. However, the impact of AH on cardiorespiratory fitness (CRF) and its potential mechanisms remains insufficiently investigated. We compared cardiopulmonary function during exercise testing (CPET) between adults with and without AH (part 1) and evaluated the effects of high-intensity interval training (HIIT) in adults with AH on submaximal cardiopulmonary CPET parameters (part 2).</p><p><strong>Methods: </strong>Thirty-eight adults with AH and 19 controls without AH partook in the study. Adults with AH were randomized into either HIIT or a control group. CPET assessed CRF and submaximal exercise parameters, including the oxygen uptake efficiency slope (OUES), V̇E/V̇CO 2 slope, PETCO 2 , V̇O 2 /work rate (WR) slope, and O 2 pulse. The HIIT intervention consisted of triweekly sessions over 8 weeks.</p><p><strong>Results: </strong>Adults with AH had a 6.5 ml kg -1  min -1 (95% confidence interval: 1.7-11.3) lower CRF, a steeper V̇E/V̇CO 2 slope (moderate-large effect size), lower PETCO 2 (large effect size), flatter V̇O 2 /WR slope (moderate effect size), and lower O 2 pulse (small-moderate effect size) than adults without AH. HIIT improved CRF and altered certain cardio-circulatory parameters in AH, including OUES (small-large effect size), V̇O 2 /WR slope (small-moderate effect size, low precision) and O 2 pulse (small-moderate effect size). However, effects of HIIT on pulmonary-vascular parameters were inconclusive, with large variability observed in the V̇E/V̇CO 2 slope and PETCO 2 .</p><p><strong>Conclusion: </strong>Adults with controlled AH might have lower CRF, indicating limitations in pulmonary-vascular and cardio-circulatory organ systems. A short-term 8-week HIIT enhances CRF and cardio-circulatory function, however, evidence is limited for improvements in pulmonary-vascular function.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1881-1889"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562091","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 exercise on aerobic capacity in people with prehypertension or hypertension: a systematic review and meta-analysis of randomized controlled trials.","authors":"Kongwen Chen, Yin Liang, Tingyun Yin, Yuanyuan Lv, Laikang Yu","doi":"10.1097/HJH.0000000000004405","DOIUrl":"10.1097/HJH.0000000000004405","url":null,"abstract":"<p><p>This study aimed to quantify the effects of exercise on aerobic capacity in people with prehypertension or hypertension and to identify exercise prescription parameters that optimize improvements. A comprehensive search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Scopus from inception to 24 October 2025. Data were pooled using standardized mean differences (SMDs) with 95% confidence intervals (CI). Fifteen studies met the inclusion criteria. Exercise significantly improved aerobic capacity in people with prehypertension or hypertension (SMD = 0.88; 95% CI: 0.61-1.15; P  < 0.00001), with multicomponent training demonstrating superior efficacy. Exploratory subgroup analyses suggest that longer programs (≥12 weeks), lower frequency (<3 sessions/week), 60-min sessions or longer, total weekly exercise less than 180 min, and professional supervision may be associated with better outcomes.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1708-1720"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673843","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":"Hypertension treatment and risk of cardiovascular disease or mortality across risk equations: results from SPRINT.","authors":"Benjamin Grobman, Frances M Wang, Azuka Amaka Ngige, Shreyas Rajesh, Mingyu Zhang, Timothy B Plante, Stephen P Juraschek","doi":"10.1097/HJH.0000000000004397","DOIUrl":"10.1097/HJH.0000000000004397","url":null,"abstract":"<p><p>The 2025 AHA/ACC blood pressure (BP) management guidelines recommend BP treatment for 10-year cardiovascular disease (CVD) ≥7.5% from the PREVENT equation, replacing the prior pooled cohort equations (PCE). We examined associations between risk in PCE and PREVENT and a composite of CVD or cardiovascular death in SPRINT. Among 1794 participants, 477 (26.6%) were at low risk in both, 119 (6.6%) were high-risk in PREVENT only, 89 (5.0%) were high-risk in PCE only, and 1109 (61.8%) were high-risk in both. Those at high risk in both equations receiving intensive treatment had a lower risk of the primary outcome [hazard ratio (HR): 0.46, 95% confidence interval (CI): 0.24, 0.89]. Intensive treatment did not affect the risk of any outcomes for those at high-risk in PREVENT only or PCE only due to low event rates. These findings confirm the neutrality of the change from PCE to PREVENT for BP treatment recommendations.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1890-1892"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673936","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":"Efficacy and safety of selective aldosterone synthase inhibitors for blood pressure reduction in patients with CKD: a meta-analysis of randomized controlled trials.","authors":"Marieta Theodorakopoulou, Fotini Iatridi, Aikaterini Theodosiadi, Manfred Hecking, Giovanni Strippoli, Pantelis Sarafidis","doi":"10.1097/HJH.0000000000004399","DOIUrl":"10.1097/HJH.0000000000004399","url":null,"abstract":"<p><p>Aldosterone synthase inhibitors (ASIs) demonstrated significant blood pressure (BP) lowering efficacy in patients with uncontrolled hypertension, but evidence in chronic kidney disease (CKD) remains limited. This meta-analysis explores the effects of selective ASIs on BP levels in CKD. Secondary outcomes were albuminuria (UACR), eGFR change and hyperkalemia incidence. Five RCTs (1,148 patients) were included; 2 used baxdrostat, 2 lorundrostat, and 1 study used vicadrostat. Treatment with ASIs was associated with a significant placebo-adjusted reduction in SBP of-7.9 mmHg [95% confidence interval (CI) -10.0 to -5.9, I2  = 0%] and DBP of -3.1 mmHg (95% CI -5.9 to -0.2, I2  = 62%) and reduced UACR by -31.7% (95% CI -54.5 to -8.9, I2  = 91%). The pooled placebo-adjusted eGFR change was -2.05 ml/min/1.73 m 2 (95% CI -3.15 to -0.95, I2  = 0%). The risk of hyperkalemia was higher with ASIs, but with high heterogeneity (risk ratio, 4.04 [95% CI 0.94 to 17.35], I2  = 76%). In conclusion, selective ASIs present a potential treatment option for BP control and albuminuria reduction in patients with CKD.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1684-1691"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673917","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":"Nighttime blood pressure versus non-dipping for predicting asymptomatic organ damage in young individuals.","authors":"Aikaterini Theodosiadi, Anastasios Kollias, Emelina Stambolliu, Angeliki Ntineri, Antonios Destounis, Ariadni Menti, Maria-Elena Zeniodi, George Servos, Andriani Vazeou, George S Stergiou","doi":"10.1097/HJH.0000000000004392","DOIUrl":"10.1097/HJH.0000000000004392","url":null,"abstract":"<p><strong>Background: </strong>Circadian blood pressure (BP) phenotypes are associated with cardiovascular risk, though understudied in youth. This study in young individuals investigated the association of nighttime BP with measures of hypertension mediated organ damage (HMOD), primary endpoint of interest in this low absolute cardiovascular risk population.</p><p><strong>Methods: </strong>Individuals aged 6-25 years were evaluated with 24-h ambulatory BP monitoring (ABPM). HMOD investigation included echocardiographic left ventricular mass index (LVMI) and ultrasonographic common carotid artery intima-media thickness (IMT).</p><p><strong>Results: </strong>Two hundred and seventy-six individuals were included (mean age 13.8 ± 3.8 years, 67% males) with ABPM data (23.6% ABPM hypertension, 26.4% nighttime hypertension, 30.4% non-dippers) and LVMI (n = 257) and/or IMT (n = 205). BP and HMOD indices increased with age, whereas non-dipping prevalence was not associated with age. Non-dippers vs. dippers had higher LVMI (30.5 ± 8.2 vs. 28.4 ± 5.95 g/m2.7, P = 0.01) and IMT (0.52 ± 0.05 vs. 0.50 ± 0.05 mm, P = 0.02), adjusted for age, sex, body mass index z-score (BMIz) and 24-h systolic BP (SBP). Individuals with nighttime hypertension vs. nighttime normotension had higher LVMI (32.76 ± 8.02 vs. 27.69 ± 5.65 g/m2.7, P < 0.001) and a trend towards higher IMT (0.52 ± 0.06 vs. 0.50 ± 0.05 mm, P = 0.16), adjusted for age, sex and BMIz. Dippers and non-dippers with nighttime hypertension had higher LVMI than dippers with nighttime normotension (all P < 0.05). In multivariable models, non-dipping independently associated with LVMI/ IMT (β = -2.14/-0.02, all P < 0.05), after adjustment for 24-h SBP, but not for nighttime SBP (β = -0.9/-0.01, for LVMI/IMT, respectively, all P = NS).</p><p><strong>Conclusions: </strong>In young individuals asymptomatic HMOD is associated with both nocturnal hypertension and non-dipping. However, nighttime BP levels seem to have the primary contributing role.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 10","pages":"1791-1798"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818652","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":"Theoretical foundations of bloodletting therapy for primary hypertension in the southern school of Tibetan medicine: insights from Qinghai-Tibet Plateau medical theory.","authors":"Wujin Danzeng, Ciwang Duoji, Gama Gele, Ga Wu","doi":"10.1097/HJH.0000000000004396","DOIUrl":"10.1097/HJH.0000000000004396","url":null,"abstract":"<p><p>Primary hypertension (PH) remains a significant contributor to global morbidity and mortality. While contemporary biomedical treatments are widely utilized, traditional medical systems such as Tibetan medicine provide distinctive diagnostic frameworks and therapeutic modalities. Among these, venesection therapy constitutes a key external intervention, frequently employed in managing conditions corresponding to PH, referred to in classical texts as Trak lung tö tsang (khrag rlung stod 'tshangs, blood-wind proliferation). This narrative review synthesizes evidence from classical Tibetan medical literature and modern clinical and experimental studies, without a systematic search of primary biomedical literature. This study conducts a comprehensive review of classical Tibetan medical literature to elucidate the theoretical origins of venesection therapy as practiced in the southern school of Tibetan medicine, with a particular focus on its application for Trak lung tö tsang (khrag rlung stod 'tshangs, blood-wind proliferation). Additionally, the analysis explores potential theoretical convergence between traditional concepts and current biomedical understandings of hypertension pathophysiology. Clarifying the theoretical underpinnings and scientific relevance of this traditional therapy may contribute to integrative approaches for managing PH, as well as to the scientific validation and the preservation of traditional Tibetan medical practices. This review also aims to inform the development of complementary and alternative therapeutic strategies for the broader management of PH.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 10","pages":"1677-1683"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818704","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":"BRCA2-deficient endothelium: a hidden catalyst in angiotensin II-induced vascular injury.","authors":"Aman Singh, Shuhan Bu, Alexander V Perron, Kriti S Bhatt, Inderbir S Sandhu, Jefferson C Frisbee, Krishna K Singh","doi":"10.1097/HJH.0000000000004407","DOIUrl":"10.1097/HJH.0000000000004407","url":null,"abstract":"<p><strong>Background: </strong>Mutations in the breast cancer susceptibility gene 2 ( BRCA2 ) are well known to increase the risk of breast and ovarian cancers. Emerging evidence indicates that BRCA2 mutation carriers exhibit increased vascular disorder and may develop endothelial dysfunction, a key mechanism underlying hypertension. Angiotensin II (Ang II), a central effector of the renin-angiotensin system, is a key regulator of blood pressure and a major driver of hypertension, promoting endothelial injury through oxidative stress, inflammation, and impaired nitric oxide (NO) bioavailability. However, the role of endothelial BRCA2 in Ang II-induced endothelial dysfunction remains unknown.</p><p><strong>Methods: </strong>BRCA2 was silenced in cultured endothelial cells and following Ang II treatment, ROS generation, DNA damage, apoptosis, inflammation, NO production, migration, angiogenic capacity, Ang II receptors and related signaling pathways were assessed.</p><p><strong>Results: </strong>BRCA2 deficiency exacerbated Ang II-induced increases in ROS, DNA damage, and apoptosis, along with impaired functional capacity, including reduced migration and angiogenesis. NO production was suppressed, accompanied by increased micronuclei formation and enhanced c-Jun N-terminal kinase (JNK) activation. In addition, both BRCA2 loss and Ang II treatment upregulated the Ang II receptor AT1R. Pharmacological inhibition of AT1R attenuated Ang II-induced increases in DNA damage and apoptosis in BRCA2 -deficient endothelial cells.</p><p><strong>Conclusion: </strong>These findings provide the first pharmacogenomic evidence that BRCA2 deficiency sensitizes endothelial cells to Ang II-induced dysfunction, suggesting that BRCA2 mutation carriers may be at increased risk for hypertension-associated cardiovascular complications.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1830-1852"},"PeriodicalIF":5.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673859","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}