Journal of HypertensionPub Date : 2025-11-01Epub Date: 2025-08-11DOI: 10.1097/HJH.0000000000004117
Victor J M Zeijen, Martijn J Tilly, Kari A Saville, Bruno H C Stricker, Isabella Kardys, M Kamran Ikram, Maryam Kavousi, Joost Daemen
{"title":"Long-term safety and efficacy of renal sympathetic denervation in comparison to a population-based cohort: a propensity-matching approach.","authors":"Victor J M Zeijen, Martijn J Tilly, Kari A Saville, Bruno H C Stricker, Isabella Kardys, M Kamran Ikram, Maryam Kavousi, Joost Daemen","doi":"10.1097/HJH.0000000000004117","DOIUrl":"10.1097/HJH.0000000000004117","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the long-term changes in risk of cardiovascular outcomes and blood pressure (BP) in hypertensive patients treated with renal sympathetic denervation (RDN) as compared to hypertensive controls from a population-based cohort.</p><p><strong>Methods: </strong>This prospective cohort study included patients with office systolic blood pressure (SBP) at least 140 mmHg and/or diastolic BP at least 90 mmHg. Patients treated with RDN were matched to hypertensive controls from the population-based Rotterdam Study using one-to-many variable-ratio propensity score matching. The primary safety outcome was a composite endpoint of myocardial infarction, coronary revascularization, stroke, renal failure and mortality. The primary efficacy outcome was the 5-year change in office SBP.</p><p><strong>Results: </strong>A total of 53 RDN patients were matched to 238 population-based controls. Median age [25th-75th percentile] was 60.5 [56.5-68.4] years (46% female). Baseline BP ±SD was 166.1/95.5 ± 20.6/10.9 mmHg. Patients were prescribed 2.8 [1.5-4.5] defined daily dosages of antihypertensive drugs. The incidence of the primary safety outcome was similar among the RDN group and the control group at 5 years [13 vs. 18%; hazard ratio 0.93; 95% confidence interval (CI) 0.36-2.38; P = 0.87]. The 5-year change in SBP was -12.0 [-18.0, -6.0] mmHg in the RDN group ( P < 0.001) and -14.9 [-22.5 to -7.3] mmHg in the control group ( P < 0.001), with no significant between-group difference [2.9 (-6.6 to 12.4) mmHg; P = 0.55].</p><p><strong>Conclusion: </strong>Patients with uncontrolled hypertension undergoing RDN did not have a significantly lower risk for future adverse cardiovascular events as compared to hypertensive controls from a population-based study. No difference in office BP was observed at 5 years. While real-world observational data could provide valuable insights, randomized trials are needed to confirm the role of RDN in improving long-term outcomes.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1832-1840"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957055","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}
Journal of HypertensionPub Date : 2025-11-01Epub Date: 2025-08-20DOI: 10.1097/HJH.0000000000004123
Frances Rose, Richard S Stevens, Kate S Morton, Lucy Yardley, Richard J McManus
{"title":"How often should self-monitoring of blood pressure be repeated? A secondary analysis of data from two randomized controlled trials.","authors":"Frances Rose, Richard S Stevens, Kate S Morton, Lucy Yardley, Richard J McManus","doi":"10.1097/HJH.0000000000004123","DOIUrl":"10.1097/HJH.0000000000004123","url":null,"abstract":"<p><strong>Background: </strong>Little evidence exists around the optimal frequency of self-monitoring of blood pressure (BP). Testing too frequently can lead to erroneous management changes due to random \"noise\" leading to raised measurements by chance. This study used recent trial data to evaluate self-monitored BP over time, aiming to determine how frequently patients should self-monitor.</p><p><strong>Methods: </strong>Data from patients with home BP ≤135/85 mmHg on stable medication in the self-monitoring groups of two trials were analysed using a mixed effects model. The primary outcome was mean change in BP per month. Secondary outcomes included intra-individual BP variability, and probability of truly raised BP over time.</p><p><strong>Results: </strong>232 participants from HOMEBP, and 582 participants from TASMINH4 were included. The mean changes in systolic BP per month per study were -0.1 mmHg [standard deviation (SD) 0.6 mmHg], and -0.2mmHg [SD 0.7 mmHg], respectively. Intra-individual systolic variability (SD) per month was 4.7 and 5.1 mmHg respectively. Using TASMINH4 data, from a starting systolic BP of 130 mmHg, re-testing BP after 6 months resulted in a probability of 18% that BP ≥135 mmHg, with a 25% probability that this reflected truly raised BP; after 12 months the probability of a raised reading was 26% with a 65% probability this reflected a true rise.</p><p><strong>Conclusions: </strong>In the absence of medication changes, there was very little change in mean self-monitored BP per month, with larger variability within an individual's monthly submitted readings. For people with initially controlled BP and stable medication, repeating self-monitoring at 12 months is likely to be appropriate in guiding management.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1863-1870"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957072","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}
Journal of HypertensionPub Date : 2025-11-01Epub Date: 2025-05-21DOI: 10.1097/HJH.0000000000004056
Ruan Kruger, Jeanne Hersant, Vimarsha Kodithuwakku, Michél Strauss-Kruger, Manish D Sinha, Madeleine Johansson, Mieczysław Litwin, Henner Hanssen, Karsten Königstein, Erzsébet V Hidvégi, Lee Stoner, Keeron Stone, Christopher J A Pugh, Catharina M C Mels, Yolandi Breet, Wayne Smith, Daniel Bia, Yanina Zócalo, Alejandro Diaz, Anuradha Khadilkar, Vikas R Dharnidharka, Giacomo Pucci, Elaine M Urbina, Rosa-Maria Bruno, Peter M Nilsson, Rachel E Climie
{"title":"Defining early vascular aging in youth: an expert consensus document from the youth vascular consortium.","authors":"Ruan Kruger, Jeanne Hersant, Vimarsha Kodithuwakku, Michél Strauss-Kruger, Manish D Sinha, Madeleine Johansson, Mieczysław Litwin, Henner Hanssen, Karsten Königstein, Erzsébet V Hidvégi, Lee Stoner, Keeron Stone, Christopher J A Pugh, Catharina M C Mels, Yolandi Breet, Wayne Smith, Daniel Bia, Yanina Zócalo, Alejandro Diaz, Anuradha Khadilkar, Vikas R Dharnidharka, Giacomo Pucci, Elaine M Urbina, Rosa-Maria Bruno, Peter M Nilsson, Rachel E Climie","doi":"10.1097/HJH.0000000000004056","DOIUrl":"10.1097/HJH.0000000000004056","url":null,"abstract":"<p><p>The concept of early vascular aging (EVA) was introduced to identify adults at risk of developing premature cardiovascular disease. EVA, or the dissociation between chronologic and biologic age of large arteries, is an evolving concept. In this review, we propose that EVA in youth characterizes the early life biological and environmental risk factors that precede overt EVA. During early infancy, childhood and/or adolescence, structural and/or functional characteristics of the macrovascular and/or microvascular system may deviate from that expected for the chronological age of the individual. Assessing vascular aging from a young age may help detect and prevent the early onset of cardiovascular disease. This consensus document from the Youth Vascular Consortium outlines the principles of EVA in youth (birth to 24 years), examines factors influencing vascular growth, and identifies current knowledge gaps. It also provides an expert consensus on defining EVA in youth. Supplementary Tables 1-3, http://links.lww.com/HJH/C733 , http://links.lww.com/HJH/C734 , http://links.lww.com/HJH/C735 supply key references for risk factors associated with EVA at different points in development; 1. Neonates to childhood; 2. Adolescence; 3. Young adults. Supplementary Table 4, http://links.lww.com/HJH/C736 displays reference ranges of EVA in adults.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1743-1749"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873512","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 of insulin resistance surrogate with resistant hypertension and the severity of hypertension in the chronic kidney disease population.","authors":"Kunming Bao, Dongjun Bao, Zhidong Huang, Wenjun Gu, Kaihong Chen","doi":"10.1097/HJH.0000000000004118","DOIUrl":"10.1097/HJH.0000000000004118","url":null,"abstract":"<p><strong>Background: </strong>Extensive research has explored the relationship between the triglyceride-glucose (TyG) index and hypertension, yet the associations of the TyG index with resistant hypertension and the severity of hypertension in the chronic kidney disease (CKD) population remain unclear.</p><p><strong>Methods: </strong>We analyzed data from 3944 CKD participants in the NHANES survey (1999-2020). Binary and ordered logistic regression analyses assessed the TyG index's impact on hypertension categories (uncontrolled, resistant, and refractory hypertension) and severity.</p><p><strong>Results: </strong>Higher TyG index quartiles were significantly associated with higher odds of hypertension categories after adjustments for covariates. Specifically, the odds ratios (ORs) for the highest quartile were 1.68 (1.27-2.22) for uncontrolled hypertension, 2.24 (1.41-3.58) for resistant hypertension, and 2.17 (1.18-3.99) for refractory hypertension compared to the lowest quartile. The continuous TyG index showed similar trends, with ORs of 1.28 (1.10-1.49), 1.54 (1.23-1.94), and 1.40 (0.97-2.01), respectively. Higher TyG index levels were also linked to greater hypertension severity. The ORs (Q2, 3, 4 vs. Q1) were 1.29 (1.01-1.65), 1.37 (1.10-1.72), and 1.80 (1.40-2.32), respectively. Each one-unit increase in the TyG index raised the OR for hypertension severity to 1.34 (1.17-1.53).</p><p><strong>Conclusion: </strong>This study demonstrated that an elevated TyG index is significantly associated with higher odds of uncontrolled, resistant, and refractory hypertension, as well as greater severity of hypertension. The findings underscored the utility of the TyG index as a valuable biomarker for evaluating resistant hypertension risk and hypertension severity among patients with CKD in community settings.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1841-1851"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956983","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}
Journal of HypertensionPub Date : 2025-11-01Epub Date: 2025-10-02DOI: 10.1097/HJH.0000000000004112
Cesare Cuspidi, Marijana Tadic, Guido Grassi
{"title":"New findings bearing on home blood pressure and cardiovascular prognosis in patients with left ventricular hypertrophy.","authors":"Cesare Cuspidi, Marijana Tadic, Guido Grassi","doi":"10.1097/HJH.0000000000004112","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004112","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 11","pages":"1791-1792"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199655","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}
Journal of HypertensionPub Date : 2025-11-01Epub Date: 2025-08-13DOI: 10.1097/HJH.0000000000004119
Maximilian Seidel, Lukas Kaess, Felix S Seibert, Moritz Anft, Sarah Skrzypczyk, Ulrik Stervbo, Eva Kohut, Ulas Ceylan, Jeremias Motte, Ralf Gold, Nina Babel, Timm H Westhoff
{"title":"The effects of propionate on blood pressure and arterial function.","authors":"Maximilian Seidel, Lukas Kaess, Felix S Seibert, Moritz Anft, Sarah Skrzypczyk, Ulrik Stervbo, Eva Kohut, Ulas Ceylan, Jeremias Motte, Ralf Gold, Nina Babel, Timm H Westhoff","doi":"10.1097/HJH.0000000000004119","DOIUrl":"10.1097/HJH.0000000000004119","url":null,"abstract":"<p><p>The short-chain fatty acid propionate has been shown to attenuate atherosclerosis, for example by modulating intestinal cholesterol metabolism. Beyond cholesterol metabolism, data from rodent models suggest a potential additional effect on blood pressure reduction. We conducted a prospective uncontrolled, exploratory, and observational study on 58 individuals receiving propionate supplementation (500 mg twice daily) without preexisting atherosclerotic cardiovascular disease, assessing peripheral and central blood pressure, arterial stiffness, and endothelial function. All parameters were measured at baseline and follow-up after 3 months. Propionate supplementation was associated with a significant reduction in peripheral systolic (-2.4 mmHg, P = 0.0181, Cohen's d = 0.17) and diastolic (-2.5 mmHg, P = 0.0155, Cohen's d = 0.27) blood pressure, as well as central DBP (-2.4mmHg, P = 0.0198, Cohen's d = 0.26). Regulatory T-cell frequency increased significantly ( P = 0.0036). No changes were observed in pulse wave velocity, flow-mediated dilatation, and cytokine concentrations. Propionate supplementation is associated with a mild reduction in blood pressure in a rather normotensive population of individuals without preexisting atherosclerotic disease.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1894-1898"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957032","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":"Neurofibromatosis 2 alleviates ferroptosis and fibrosis in the aortas of spontaneously hypertensive rats through the Yes-associated protein pathway.","authors":"Rui Xu, Huiying Wang, Yongkang Wei, Tingting Jiang, Siting Hong, Tingting Song, Yuanyuan Jin, Biying Jiang, Chunjie Sui, Yong Zhao, Yu Fu","doi":"10.1097/HJH.0000000000004120","DOIUrl":"10.1097/HJH.0000000000004120","url":null,"abstract":"<p><p>Neurofibromatosis 2 (NF2) is a tumor suppressor gene that plays a pivotal role in regulating cell growth and survival. There was evidence that patients with NF2 gene mutations have higher blood pressure. However, the specific role of NF2 in vascular remodeling caused by hypertension remains poorly understood. In this study, we found that NF2 expression was decreased in the aortas of spontaneously hypertensive rats (SHRs), and identified it as a critical regulator in vascular smooth muscle cells (VSMCs). Overexpression of NF2 in SHRs led to a reduction in blood pressure, alleviated vascular remodeling and mitigated aortic ferroptosis and fibrosis. Mechanistic investigations revealed that NF2 exerted its effects by modulating Yes-associated protein (YAP), preventing its nuclear translocation. Notably, the beneficial effects of NF2 overexpression were reversed by the administration of YAP agonist (PY60). Similar results were obtained in vitro. Our findings highlight the critical role of NF2 in regulating vascular remodeling and provide new insights for potential therapeutic strategies targeting NF2 and YAP in hypertension-related vascular complications.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1852-1862"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131120","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}
Journal of HypertensionPub Date : 2025-11-01Epub Date: 2025-08-20DOI: 10.1097/HJH.0000000000004111
Aleksander Prejbisz, Piotr Dobrowolski, Gabriel Bozek, Beata Koń, Aneta Machnio, Witold Śmigielski, Filip Urbański, Filip Nowak, Maciej Miłkowski, Roman Topór-Mądry, Jacek Wolf, Krzysztof Narkiewicz, Pankaj Gupta, Michel Burnier
{"title":"Patterns of prescription of antihypertensive medications in Poland: a one-year assessment of initiation and persistence of therapy in a nationwide population cohort.","authors":"Aleksander Prejbisz, Piotr Dobrowolski, Gabriel Bozek, Beata Koń, Aneta Machnio, Witold Śmigielski, Filip Urbański, Filip Nowak, Maciej Miłkowski, Roman Topór-Mądry, Jacek Wolf, Krzysztof Narkiewicz, Pankaj Gupta, Michel Burnier","doi":"10.1097/HJH.0000000000004111","DOIUrl":"10.1097/HJH.0000000000004111","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the prescribing patterns and treatment persistence of antihypertensive medications over a 12-month period in a nationwide cohort from Poland.</p><p><strong>Methods: </strong>We examined data on all 141 668 patients in Poland who received their first hypertension prescription in January 2021, sourced from the e-Health Centre database encompassing all filled prescriptions. Treatment persistence over the first 12 months was assessed as a measure of long-term adherence. We assessed the degree of persistence to therapy as the percentage of patients having a supply of the drug for each consecutive month until the end of follow-up.</p><p><strong>Results: </strong>Antihypertensive therapy was started with a monotherapy in 57% of cases; 23% (21% of women and 25% of men; P < 0.001) started with a two-drug antihypertensive combination and 13% (11% of women, 17% of men; P < 0.001) with a single-pill combinations (SPCs). Only 33% of patients (29% of women, 36% of men; P < 0.001) received drug classes combinations endorsed by guidelines. Treatment persistence after 1 year exhibited significant age-related disparities - persisting in 17-53% among younger and middle-aged individuals, and 59-87% among older patients. Initiation with an SPC was associated with higher 1-year persistence. Among patients still on antihypertensive therapy at 12 months, 30% were on monotherapy, 27% on two drugs, and 43% on three or more agents.</p><p><strong>Conclusion: </strong>In Poland, monotherapy is the predominant first line treatment of hypertension. A substantial proportion of younger and middle-aged patients discontinue therapy within the first year. The use of SPCs at initiation is associated with an improved long-term persistence.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1823-1831"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association of blood pressure variability and incidence of stroke: a systematic review and meta-analysis.","authors":"Eleftheria Stamou, Panagiotis Iliakis, Dimitrios Konstantinidis, Eleni Manta, Konstantinos G Kyriakoulis, Alexandros Kasiakogias, Kyriakos Dimitriadis, Efstathios Manios, Anastasios Kollias, Georgios Tsivgoulis, Konstantinos Tsioufis","doi":"10.1097/HJH.0000000000004129","DOIUrl":"10.1097/HJH.0000000000004129","url":null,"abstract":"<p><p>Blood pressure variability (BPV) has emerged as a significant risk factor for cardiovascular events and mortality. The association between BPV and the incidence of cerebrovascular events is increasingly recognized as crucial in understanding stroke risk management. This review aims to investigate the relationship between BPV and the incidence of stroke. A comprehensive literature review was conducted using the PubMed database for studies published between 2010 and 2024. A total of 23 studies were included in this review, providing insight into short-term, mid-term and long-term BPV and their respective impacts on stroke risk. The studies reviewed consistently indicate that increased BPV, especially long-term, is strongly correlated with a higher risk of ischemic and hemorrhagic strokes. A meta-analysis of 17 studies ( n = 3 130 248 participants, weighted mean age 59 years, median follow-up 4.6 years) indicated hazard ratio of increasing systolic visit-to-visit BPV for incident stroke (adjusted for mean blood pressure) 1.40, 95% confidence intervals (1.10-1.77). BPV is an important factor in predicting stroke risk, independent of mean blood pressure levels. Managing BPV may offer an additional therapeutic target, both for primary and secondary prevention.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1764-1772"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131148","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}
Journal of HypertensionPub Date : 2025-11-01Epub Date: 2025-09-03DOI: 10.1097/HJH.0000000000004104
Yanxia Chen, Ben Ke, Minzi Qiu, Chen Yan, Honghong Zou, Wei Tu
{"title":"Role of E2F1 , taking account for the transcriptional activity of lncRNA HOTAIR , in vascular calcification via epigenetic silencing of KLF16/Klotho.","authors":"Yanxia Chen, Ben Ke, Minzi Qiu, Chen Yan, Honghong Zou, Wei Tu","doi":"10.1097/HJH.0000000000004104","DOIUrl":"10.1097/HJH.0000000000004104","url":null,"abstract":"<p><strong>Background: </strong>Vascular calcification is a significant complication in patients with chronic kidney disease (CKD), which is closely related to hyperphosphatemia. However, its mechanism has not been fully elucidated yet. We mainly investigated the novel role and mechanism of transcription factor E2F transcription factor 1 (E2F1) by targeting lncRNA HOX transcript antisense intergenic RNA (HOTAIR) in high phosphate (Pi)-induced vascular calcification.</p><p><strong>Methods: </strong>Differential expressions of several candidates in E2F transcription factor family were assessed by RT-qPCR and Western blot analysis in both in-vitro and in-vivo models.Calcification of human aortic smooth muscle cells (HASMCs) was evaluated through Alizarin Red S staining, measurement of Ca 2+ content, and assessment of alkaline phosphatase (ALP) activity. Subcellular localization of HOTAIR was detected utilizing subcellular fractionation and fluorescent in-situ hybridization (FISH). Chromatin immunoprecipitation (ChIP), luciferase reporter and RNA immunoprecipitation (RIP) assays were performed to validate the role of E2F1/HOTAIR in Krüppel-like factor 16 (KLF16)/Klotho axis. Concentrations of serum creatinine (Scr) and urine nitrogen (BUN) were measured to assess renal function in mice, followed by the evaluation of vascular calcification in mouse aorta ring.</p><p><strong>Results: </strong>E2F1, identified as significantly downregulated in HASMCs following Pi treatment, was found to be a transcriptional activator of HOTAIR. E2F1 overexpression attenuated Pi-induced HASMCs calcification, which was reversed by HOTAIR silencing. HOTAIR acted as a scaffold for lysine-specific demethylase 1A (KDM1A) and enhancer of zeste homolog 2 (EZH2), contributing to the epigenetic suppression of KLF16. KLF16, in turn, acted as a transcriptional inhibitor for Klotho, thereby suppressing Pi-triggered HASMCs calcification. Additionally, E2F1 overexpression alleviated calcium deposition in thoracic aorta of Pi-induced mice, which was overturned after HOTAIR silencing.</p><p><strong>Conclusion: </strong>HOTAIR, transcriptionally activated by E2F1, exerts a protective effect against vascular calcification by modulating KLF16/Klotho axis. This protective mechanism involves recruitment of KDM1A and EZH2. These findings provide potential new therapeutic targets for CKD treatment.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1802-1815"},"PeriodicalIF":4.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131162","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}