Journal of Hypertension最新文献

{"title":"Chronic esaxerenone treatment improves vascular function and lowers peripheral arterial stiffness in patients with idiopathic hyperaldosteronism.","authors":"Shinji Kishimoto, Tatsuya Maruhashi, Masato Kajikawa, Aya Mizobuchi, Takahiro Harada, Takayuki Yamaji, Yukiko Nakano, Chikara Goto, Farina Mohamad Yusoff, Yukihito Higashi","doi":"10.1097/HJH.0000000000004030","DOIUrl":"10.1097/HJH.0000000000004030","url":null,"abstract":"<p><strong>Objective: </strong>Primary aldosteronism is one of the most common types of secondary endocrine hypertension. Treatment with mineralocorticoid receptor antagonists is recommended for bilateral idiopathic hyperaldosteronism (IHA). The purpose of this study was to evaluate the effects of esaxerenone, a nonsteroidal mineralocorticoid receptor antagonist with high mineralocorticoid receptor-binding specificity, on vascular function and peripheral arterial stiffness in patients with IHA.</p><p><strong>Methods: </strong>This study was a single-center, observational prospective cohort study. Forty-four patients with IHA (18 men and 26 women; 52 ± 11 years) were enrolled from Hiroshima University Hospital. Vascular function, including flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) and peripheral arterial stiffness, including brachial-ankle pulse wave velocity (baPWV) and brachial artery intima-media thickness (bIMT) were measured before and after 12 weeks of treatment with esaxerenone.</p><p><strong>Results: </strong>Esaxerenone treatment increased FMD (3.1 ± 2.0% to 5.7 ± 2.2%, P  < 0.01) and NID (10.7 ± 3.8% to 15.7 ± 6.2%, P  < 0.01) and decreased baPWV (1605 ± 263 to 1428 ± 241 cm/s, P  < 0.01), while esaxerenone treatment did not significantly alter bIMT. The changes in FMD and NID posttreatment with esaxerenone were significantly correlated with the changes in plasma aldosterone concentration (PAC) and plasma renin activity (PRA). The change in baPWV was significantly correlated with the changes in PRA, aldosterone-to-renin ratio, and systolic blood pressure.</p><p><strong>Conclusion: </strong>Esaxerenone improved vascular function and peripheral arterial stiffness in patients with IHA. These findings suggest aldosterone inhibition is a potential mechanism governing improvement in cardiovascular health.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1205-1213"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110412","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 events and biochemically negative paragangliomas: a systematic review.","authors":"George Tsorbatzoglou, Foteini Thanasoula, Chrysoula Mytareli, Elisavet Tasouli, Alexandros Smyrnis, Konstantinos Kontzoglou, Gregory Kaltsas, Anna Angelousi","doi":"10.1097/HJH.0000000000004026","DOIUrl":"10.1097/HJH.0000000000004026","url":null,"abstract":"<p><strong>Objective: </strong>To study cardiovascular morbidity in patients with biochemically inactive pheochromocytomas/paragangliomas.</p><p><strong>Methods: </strong>PubMed, Cochrane, and Scopus databases were searched by two independent reviewers to identify relevant studies. Twenty-four case reports ( n  = 24 patients) met the inclusion criteria providing data on the cardiovascular status of biochemically negative pheochromocytomas/paragangliomas patients. Methodological quality was assessed by the Grading of Recommendations, Assessment, Development and Evaluations system, and all included studies were assessed for the risk of bias. This systematic review was conducted in conformance with the PRISMA statement and registered to PROSPERO (ID: CRD42024530601).</p><p><strong>Results: </strong>Almost half of patients (46%) presented objective abnormal findings on noninvasive cardiovascular examination performed routinely before surgery, whereas 67% complained of pheochromocytoma/paraganglioma-related symptoms (angina, headache, diaphoresis, shortness of breath, palpitations) and exhibited relevant clinical signs (hypertension, tachycardia, tachypnea, pallor). Preoperatively, only 38% of patients with biochemically negative pheochromocytomas/paragangliomas were treated with alpha-blockers, 25% did not receive any pharmaceutical preparation whereas data were not available for the remaining 37% of patients. Following an uneventful surgery, 70% of patients exhibited resolution of the preoperatively detected cardiovascular symptoms and signs.</p><p><strong>Conclusion: </strong>The high occurrence of cardiovascular abnormalities in patients with pheochromocytomas/paragangliomas characterized as \"biochemically negative\" based on routine biochemical analyses highlights the difficulty in the appropriate classification of these tumors regarding their secretory profile and thus the risk of missing cardiovascular system involvement with potentially deleterious effects.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1116-1125"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772368","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":"Admission blood pressure and blood pressure variability in medical emergency predicts 3-month mortality and readmission.","authors":"Emma Hildur Jensen Malm, Anton W Petersen, Rakin Hadad, Steen B Haugaard, Michael H Olsen, Philip L Bonde, Helena Dominguez, Edina Hadziselimovic, Ahmad Sajadieh","doi":"10.1097/HJH.0000000000004027","DOIUrl":"10.1097/HJH.0000000000004027","url":null,"abstract":"<p><strong>Background: </strong>The admission systolic blood pressure (SBP) recorded at the emergency department is typically elevated and tends to decrease, while various degrees of blood pressure variability (BPV) remain. Whether admission SBP or mean SBP and BPV from resting beat-to-beat measurements are better associated with short-term outcome remains unknown.</p><p><strong>Methods: </strong>We conducted a prospective study, including adults acutely admitted to the emergency department at a larger Danish tertiary care Hospital in Copenhagen, Denmark from 2019 to 2023. We measured blood pressure (BP) at admission and beat-to-beat BP and BPV during 10-minute rest. We defined BPV as the standard deviation from the mean of the beat-to-beat SBP measurements. Primary outcome was defined as 3-month all-cause mortality or readmission, and secondary outcome as 3-month cardiovascular mortality or readmission for cardiovascular disease.</p><p><strong>Results: </strong>Among 951 patients included, mean age was 64 (standard deviation; 17) with 44% women. During 3-month follow-up, 284 (30%) patients met a primary outcome and 69 (7,2%) a secondary outcome. In adjusted Cox models, admission SBP, but neither mean SBP or BPV, was significantly associated with primary outcome [hazard ratio 0.971, 95% confidence interval (CI) 0.948-0.995, P  = 0.017] for each 5 mmHg increase in SBP. When exploring both extremes of upper and lower quartiles, BPV greater than 10 mmHg was associated with increased cardiovascular events (hazard ratio 2.019, 95% CI 1.142-3.569, P  = 0.016).</p><p><strong>Conclusion: </strong>In this study, low admission SBP was associated with all-cause readmissions and mortality, while BPV above 10 mmHg was associated with 3-month risk of cardiovascular events.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1198-1204"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025528","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":"Optimizing hypertension management: the impact of drug class, socioeconomic factors, and simplified regimens on medication adherence. VATAHTA study.","authors":"Nicolás F Renna, Eliel Ivan Ramirez, Sergio Vissani, Beder Gustavo Farez, Belén Camaño, Martha Alcorta, Emiliano Raul Diez, Jesica Magalí Ramirez","doi":"10.1097/HJH.0000000000004023","DOIUrl":"10.1097/HJH.0000000000004023","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence is essential for managing hypertension, yet many patients fail to follow prescribed treatments. This study examines the relationships between drug class, treatment complexity, socioeconomic factors, and adherence in hypertensive patients from Argentina.</p><p><strong>Methods: </strong>A multicentre, cross-sectional study was conducted with 1144 hypertensive patients from the Cuyo region. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8). The impact of drug classes, number of prescribed drugs, dosing frequency, and socioeconomic factors (education, home ownership, employment status) on adherence was analysed using multivariate logistic regression. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated.</p><p><strong>Results: </strong>Patients on fixed-dose combinations demonstrated better adherence than those on monotherapy (OR 1.30, 95% CI: 1.15-1.45). Higher education (OR 1.20, 95% CI: 1.05-1.35) and home ownership (OR 1.15, 95% CI: 1.02-1.28) were associated with improved adherence, while unemployment was linked to reduced adherence. Patients taking more than three drugs showed lower adherence (OR 0.85, 95% CI: 0.75-0.95), and more frequent dosing (more than twice daily) was linked to reduced adherence (OR 0.78, 95% CI: 0.68-0.90). Beta-blockers (OR 2.5, 95% CI: 2.0-3.0) and potassium-sparing diuretics (OR 1.7, 95% CI: 1.3-2.1) were associated with the highest adherence, while ACE inhibitors such as ramipril (OR 0.75, 95% CI: 0.60-0.90) were linked to lower adherence.</p><p><strong>Conclusion: </strong>Simplified regimens, particularly fixed-dose combinations, and the selection of drugs with favourable adherence profiles, like beta-blockers and potassium-sparing diuretics, can improve adherence. Addressing socioeconomic barriers should also be prioritized.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1191-1197"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023106","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":"Mortality risks in different subtypes of white-coat hypertension: implications for the diagnosis of white-coat hypertension.","authors":"Alejandro de la Sierra, Luis M Ruilope, Natalie Staplin, George S Stergiou, Ernest Vinyoles, Bryan Williams","doi":"10.1097/HJH.0000000000004076","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004076","url":null,"abstract":"<p><strong>Background: </strong>The risk associated with white-coat hypertension is controversial. We evaluated mortality risks in white-coat hypertension subtypes defined according to the circadian pattern of blood pressure (BP) elevation over 24 h.</p><p><strong>Methods: </strong>In 44 119 patients with elevated office BP, white-coat hypertension subtypes were defined as normal BP in all circadian periods (day, night, and 24-h, 12 192 patients), normal 24-h, with nocturnal BP elevation (4368), and normal daytime, with 24-h BP elevation (3525). Associations of each subtype with all-cause and cardiovascular mortality were estimated by Cox-regression models, adjusted for clinical confounders, compared to a reference group of 7690 patients with normal both office and ambulatory (all periods) BP.</p><p><strong>Results: </strong>Compared to the reference group, white-coat hypertension defined by normal BP in all circadian periods was not associated with an increased risk of all-cause [hazard ratio, 0.94 [95% confidence interval, 95% CI,0.85-1.03]) or cardiovascular death (hazard ratio, 0.91 [95% CI,0.76-1.08]). In contrast, white-coat hypertension defined by normal daytime, but with elevated 24-h BP, was associated with increased risks of all-cause (hazard ratio, 1.27 [95% CI,1.13-1.42]) and cardiovascular death (hazard ratio, 1.37 [95% CI,1.12-1.68]). The group of white-coat hypertension defined by normal 24-h BP, but with nocturnal BP elevation had increased crude rates of death, but risks were not significantly increased after adjusting for confounders.</p><p><strong>Conclusion: </strong>White-coat hypertension is a heterogeneous condition in terms of associated risk of death. A definition based only on a normal daytime BP may mask a significant group of patients with increased 24-h or night BP, who exhibit an increased risk of mortality.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284980","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":"Blood pressure-lowering efficacy of Sacubitril/Allisartan versus Olmesartan in Chinese hypertensive patients with a nondipping blood pressure pattern.","authors":"Wei Zhang, Jie Yan, Jin Zhang, Qian Ge, Xiao-Hong Lu, Shao-Xing Chen, Wen-Jie Xu, Jing-Chao Sun, Jin-Feng Li, Zi-Chen Liu, Qiang Wang, Xiang-Nan Zhou, Yan Li, Ji-Guang Wang","doi":"10.1097/HJH.0000000000004065","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004065","url":null,"abstract":"<p><strong>Background: </strong>Abnormal nocturnal blood pressure dipping profile is an important cardiovascular risk factor in patients with hypertension. This analysis aimed to investigate the effects of Sacubitril/Allisartan on blood pressure in Chinese patients with mild to moderate hypertension and a nighttime nondipping pattern.</p><p><strong>Methods: </strong>We performed analysis of data from a randomized clinical trial that compared the blood pressure-lowering effect at 12 weeks of treatment with Sacubitril/Allisartan (240 or 480 mg/day) and Olmesartan (20 mg/day). Nighttime nondipping pattern was defined as mean nighttime (10 p.m. to 6 a.m.) ambulatory blood pressure fall of less than 10% versus daytime (6 a.m. to 10 p.m.) ambulatory blood pressure. The outcome measures included clinical and 24-h, daytime, and nighttime ambulatory blood pressure.</p><p><strong>Results: </strong>Of the 1197 randomized patients of the trial, 497 (41.5%) patients had a nighttime nondipping pattern and were included in this analysis. At 12 weeks, the least square mean (±standard error) changes from baseline in 24-h mean ambulatory SBP/DBP (maSBP/maDBP) in the Sacubitril/Allisartan 240 and 480 mg/day groups were -10.3 ± 1.1/-5.3 ± 0.6 and -13.7 ± 1.1/-6.7 ± 0.6 mmHg, respectively. The reductions in nighttime maSBP were significantly greater with both doses of Sacubitril/Allisartan compared with Olmesartan 20 mg [-12.7 ± 1.2/6.3 ± 0.7 mmHg, with a difference of -3.8 (-7.2 to -0.4) mmHg, P = 0.029 for Sacubitril/Allisartan 240 mg and -7.5 (-10.9 to -4.1) mmHg, P < 0.001 for Sacubitril/Allisartan 480 mg]. The 24-h mean ambulatory blood pressure and nighttime maSBP reductions in nondipper patients tended to be dose-dependent for Sacubitril/Allisartan. At 12 weeks of treatment, the prevalence of dippers was significantly (P ≤ 0.019) higher in the Sacubitril/Allisartan 240 and 480 mg groups than in the Olmesartan 20 mg group for both SBP (46.9 and 47.9 versus 33.7%) and DBP (42.0 and 40.2 versus 26.5%).</p><p><strong>Conclusion: </strong>Sacubitril/Allisartan is particularly effective in reducing nighttime blood pressure and in reversing the nondipping to dipping nighttime blood pressure pattern.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284977","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":"Sex disparities in awareness, treatment, and control of hypertension in Peru.","authors":"Carlos Diaz-Arocutipa, Rafael Salguero-Bodes, Elena Puerto, Roberto Martín-Asenjo, Lourdes Vicent","doi":"10.1097/HJH.0000000000004072","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004072","url":null,"abstract":"<p><strong>Objective: </strong>Understanding sex differences in the hypertension treatment cascade is essential, particularly in developing countries where such data are limited. This study aimed to evaluate sex differences in hypertension awareness, treatment, and control in Peru.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using data from the 2023 Peruvian Demographic and Health Survey, a nationally representative survey using a stratified, two-stage cluster sampling design. We included individuals aged at least 15 years with complete and valid blood pressure data. Hypertension was defined based on self-reports and blood pressure measurements. Binary logistic regression was used to estimate odds ratios (OR) with 95% confidence intervals (CI), and all analyses were weighted to account for the survey's complex design.</p><p><strong>Results: </strong>In total, 36 075 individuals were included (mean age 41 years; 51.9% women). The prevalence of hypertension was lower in women than in men [17.8 vs. 20.9%; odds ratio (OR) 0.66, 95% CI 0.59-0.75]. However, women exhibited significantly higher odds of hypertension awareness (70.4 vs. 41.6%; OR 3.41, 95% CI 2.70-4.30), treatment (42.8 vs. 25.3%; OR 2.05, 95% CI 1.59-2.64), and control (45.7 vs. 21.3%; OR 3.35, 95% CI 2.68- 4.18) compared to men.</p><p><strong>Conclusion: </strong>In Peru, notable sex differences exist in the hypertension treatment cascade, with women more likely than men to be aware of, treated for, and have controlled hypertension. These findings highlight the need for sex-specific strategies to improve hypertension management outcomes.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284935","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 formation of angiotensin II from angiotensin I in individuals of African descent.","authors":"Sanjay K Gandhi, Kyung-Soo Kim, K Bridget Brosnihan, Nancy J Brown","doi":"10.1097/HJH.0000000000004068","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004068","url":null,"abstract":"<p><strong>Objective: </strong>Activation of the renin-angiotensin-aldosterone system (RAAS) and African ancestry are both associated with increased end-organ damage in hypertension. An insertion (I) deletion (D) polymorphism in the gene encoding the angiotensin-converting enzyme (ACE) has been associated with ACE activity. This study tested the hypothesis that ancestry or ACE I/D genotype affects the conversion of angiotensin (Ang) I to Ang II and blood pressure, renal plasma flow, and aldosterone during Ang I or II infusion.</p><p><strong>Methods: </strong>Ang I and Ang II were infused in graded doses from 1 to 20 ng/kg/min in a randomized, single-blind, crossover study in salt-replete normotensive participants of self-identified African (Black) or European (white) ancestry who were homozygous for the ACE I/I (7 Black, 8 white) or D/D (8 Black, 8 white) genotype.</p><p><strong>Results: </strong>ACE activity was significantly increased in ACE D/D vs. ACE I/I individuals regardless of ancestry. The conversion of Ang I to Ang II was increased in Black compared to in white participants, independent of genotype. The pressor and aldosterone responses to Ang I and Ang II did not differ by ancestry or ACE I/D genotype. Basal renal plasma flow was increased in individuals of ACE D/D genotype independent of ancestry but the renal vasoconstrictor response to Ang I and Ang II did not differ by ACE genotype.</p><p><strong>Conclusions: </strong>The conversion of infused Ang I to Ang II is increased in Black compared to in white individuals. Increased Ang II could contribute to attenuated responses to RAAS interfering drugs and end-organ damage in individuals of African ancestry.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284978","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":"Blood pressure management in clinically complex scenarios: new horizons for a tailored approach.","authors":"Maria Concetta Pastore, Riccardo Liga, Enrico Emilio Diviggiano, Carlo Vitale, Alessandro Parlato, Francesca Amati, Flavio D'ascenzi, Egidio Imbalzano, Andrea Rinaldi, Pietro Scicchitano, Anna Vittoria Mattioli, Marco Matteo Ciccone, Roberto Pedrinelli, Matteo Cameli","doi":"10.1097/HJH.0000000000004025","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004025","url":null,"abstract":"<p><p>Arterial hypertension is a major preventable cardiovascular risk factor, which is estimated to be responsible of around 25% of heart attacks and 40% of cardiovascular deaths in Europe. As the prevalence of arterial hypertension is continuously growing in the general population, it is estimated that by 2025 up to 60% of the adult western population will suffer from high blood pressure (BP), making arterial hypertension a timely topic for scientific research. The management of BP in specific conditions such as heart failure, kidney diseases or paediatric patients could be challenging. In the last years, new drugs have been introduced, changing the landscape of heart failure treatment, while possibly having a significant impact on BP regulation and kidney function. Similarly, while resistant hypertension may represent a true issue for clinicians and patients, novel therapeutic approaches are now available. In this regard, while for instance renal artery denervation has been introduced as an innovative therapy for patients with resistant hypertension, it has possibly shown consistent benefits also in patients with heart failure at large, whereby it could significantly reduce sympathetic nervous activation. This review focuses on new perspectives for the management of BP in these specific populations in order to provide practical hints for a tailored approach for clinically complex and/or resistant patients.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266425","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 high-density lipoprotein cholesterol, particles and subspecies with the risk of hypertension: findings from the PREVEND prospective study.","authors":"Setor K Kunutsor, Margery A Connelly, Ashish Shah, Stephan J L Bakker, Robin P F Dullaart","doi":"10.1097/HJH.0000000000004014","DOIUrl":"10.1097/HJH.0000000000004014","url":null,"abstract":"<p><strong>Objective: </strong>The prospective associations of high-density lipoprotein cholesterol (HDL-C), HDL particle (HDL-P) and subspecies concentrations with the risk of hypertension are uncertain. We aimed to evaluate the associations of HDL parameters with incident hypertension risk and their interplay with alcohol consumption in the PREVEND study.</p><p><strong>Methods: </strong>HDL parameters as measured by nuclear magnetic resonance spectroscopy and self-reported alcohol consumption were assessed in 3263 participants (mean age, 49 years; 45.8% males) without a history of hypertension at baseline. Multivariable-adjusted hazard ratios (HRs) with 95% CIs for hypertension per 1 standard deviation increment in HDL parameters were calculated.</p><p><strong>Results: </strong>During a median follow-up of 7.2 years, 825 participants developed hypertension. In analysis adjusted for several potential confounders, including alcohol consumption, there were inverse associations of HDL-C, HDL-P, medium HDL, HDL size, H3P and H4P with hypertension risk: HRs [95% confidence interval (CI) of 0.88 (0.81-0.97), 0.92 (0.86-0.99), 0.86 (0.80-0.93), 0.89 (0.82-0.98), 0.92 (0.85-0.98), and 0.87 (0.81-0.94), respectively]. Sex or alcohol consumption did not modify the associations of HDL parameters with hypertension risk. Compared with abstainers, the multivariable adjusted HRs (95% CI) of hypertension for occasional to light, moderate and heavy alcohol consumers were 0.84 (0.70-1.00), 0.83 (0.68-1.02), and 0.97 (0.69-1.37), respectively; the associations persisted on further adjustment for HDL parameters.</p><p><strong>Conclusions: </strong>There are inverse associations of HDL-C, HDL-P, medium HDL, HDL size, H3P and H4P with hypertension risk, which are not confounded or modified by alcohol consumption. Light and moderate alcohol consumption is modestly and inversely associated with hypertension risk, independently of HDL parameters.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1066-1074"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743229","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}