Journal of Hypertension最新文献

{"title":"Nocturnal hypertension represents an uncontrolled burden in patients with metabolic dysfunction-associated steatotic liver disease.","authors":"Anna Martin, Sonja Lang, Felix Schifferdecker, Gabriel Allo, Seung-Hun Chon, Christoph Neumann-Haefelin, Münevver Demir, Hans-Michael Steffen, Philipp Kasper","doi":"10.1097/HJH.0000000000003977","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003977","url":null,"abstract":"<p><strong>Backgroundaims: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is an independent risk factor for cardiovascular morbidity and mortality. Another critical risk factor in these patients is arterial hypertension (AH). Although it is estimated that 50% of MASLD patients are suffering from AH, 24-h ambulatory blood pressure monitoring (24-h-ABPM), the gold standard for diagnosing hypertension, is often neglected. However, only 24-h-ABPM can identify hypertension subtypes, particularly nocturnal hypertension (NH), which is a stronger predictor of cardiovascular mortality than daytime or 24-h blood pressure. The aim of this study was to investigate the prevalence of NH in MASLD patients and to identify associated risk factors.</p><p><strong>Methods: </strong>To this end, 226 MASLD patients with or without known AH were prospectively recruited in an outpatient liver department and underwent 24-h-ABPM together with repeated office-blood-pressure measurements.</p><p><strong>Results: </strong>24-h-ABPM datasets from 218 patients were included in the final analysis. NH was observed in 112 patients (51.3%), of whom 54 (48.2%) were receiving antihypertensive treatment (uncontrolled hypertension). Univariable regression analysis showed that age, increased waist-to-hip ratio, a waist-to-height ratio ≥0.5, type 2 diabetes mellitus (T2DM), dyslipidemia, a lower estimated glomerular filtration rate and increased liver stiffness were significantly associated with a higher risk of NH. In multivariable regression analysis, T2DM [odds ratio (OR) 2.56; 95% confidence interval (CI) 1.09-6.23; P = 0.033], dyslipidemia (OR 3.30; 95% CI, 1.67-6.73; P = 0.001) and liver stiffness (OR 1.09; 95% CI, 1.02-1.18; P = 0.021) were identified as independent risk factors.</p><p><strong>Conclusions: </strong>In conclusion, particularly MASLD patients with accompanying T2DM, dyslipidemia, and increased liver stiffness should undergo 24-h-ABPM to detect and treat NH, as they are at the highest risk of adverse cardiovascular events.</p><p><strong>Clinical trial: </strong>NCT-04543721.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the heart rate dipping pattern associated with sleep quality during an ambulatory blood pressure monitoring? A cross-sectional study.","authors":"Carlos E Leiva Sisnieguez, Ricardo D Olano, Rodolfo N Stavile, Julián Minetto, Gustavo Cerri, Walter G Espeche, Horacio A Carbajal, Martín R Salazar","doi":"10.1097/HJH.0000000000003971","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003971","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to characterize individuals with nondipping heart rate (HR) and to assess the association between that pattern and sleep quality during the night of an ambulatory blood pressure monitoring (ABPM).</p><p><strong>Methods: </strong>Individuals who attended our Unit to perform an ABPM, from February 2022 to May 2024, were asked about clinical and epidemiological antecedents and responded two validated surveys, about sleep quality during the night of the ABPM and in the prior 30 days. Then, they were categorized according to the presence of a dipping in nocturnal HR (defined as a decline in average HR at night equal or higher than 10% compared with daytime values) as HR dippers or HR nondippers (drop in mean nighttime HR lower than 10% of diurnal mean) in order to compare the mentioned variables.</p><p><strong>Results: </strong>One thousand two hundred and nine individuals were included. They were predominantly female (61.8%), middle-aged (median 50 years, IQR 36-60), overweight (median BMI 29, IQR 25.3-33.5) and had median ABPM estimates within normal ranges. In individuals without beta-blockers (n = 1107), HR nondippers had an adverse cardiovascular disease (CVD) risk profile, and no differences were found between HR dippers and HR nondippers concerning perceived good rest during the ABPM night (63.5 vs. 59.7%, P = 0.211) and usual sleep quality. The sensitivity analysis including beta-blockers' users (n = 102) was consistent.</p><p><strong>Conclusion: </strong>A blunted dipping in mean nighttime HR identifies individuals with a high CVD risk profile and is not associated with bad sleep quality during the night of an ABPM.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior cervical ganglionectomy attenuates vascular remodeling in spontaneously hypertensive rats.","authors":"Jing-Xiao Wang, Xiao-Yu Xu, Yi-Ming Wang, Ai-Dong Chen, Yue-Hua Li, Guo-Qing Zhu, Xiao-Qing Xiong","doi":"10.1097/HJH.0000000000003883","DOIUrl":"10.1097/HJH.0000000000003883","url":null,"abstract":"<p><strong>Background: </strong>Sympathetic hyperactivity contributes to the pathogenesis of hypertension. However, it is unclear whether the excessive sympathetic activity is an independent and crucial factor for vascular remodeling in hypertension. This study focused on the effect of local sympathetic denervation with superior cervical ganglionectomy (SCGx) on vascular remodeling.</p><p><strong>Methods: </strong>Surgical bilateral SCGx was performed in 9-week-old male Wistar-Kyoto rats (WKY) and spontaneously hypertensive rats (SHR). Control rats received sham-operation without SCGx. All measurements were made 4 weeks after the surgery.</p><p><strong>Results: </strong>The effectiveness of SCGx was confirmed by the eye features of Horner syndrome, greatly reduced tyrosine hydroxylase (TH) contents in the superior cervical ganglion (SCG)-innervated arteries in the head. Although SCGx had no significant effects on blood pressure and heart rate in WKY and SHR, it attenuated vascular remodeling of facial artery and superficial temporal artery in SHR, two representative SCG-innervated extracranial arteries, without significant effects on non-SCG-innervated thoracic aorta and mesenteric artery. SCGx-treated SHR had more auricular blood flow and retina microvasculature than sham-operated SHR. However, SCGx had only a mild effect in attenuating the vascular remodeling of basilar artery and middle cerebral artery, two representative SCG-innervated intracranial arteries, in SHR. SCGx-treated SHR exhibited upregulation of α-smooth muscle actin, downregulation of proliferating cell nuclear antigen, and attenuation of oxidative stress and inflammation in facial artery and superficial temporal artery.</p><p><strong>Conclusions: </strong>Sympathetic denervation by SCGx in SHR attenuated local vascular remodeling, suggesting that sympathetic overactivity is a crucial pathogenic factor of vascular remodeling in SHR.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"236-245"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502025","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 glucagon-like peptide-1 receptor agonists on blood pressure in overweight or obese patients: a meta-analysis of randomized controlled trials.","authors":"Hon Jen Wong, Keith Zhi Xian Toh, Yao Hao Teo, Yao Neng Teo, Mark Y Chan, Leonard L L Yeo, Pei Chia Eng, Benjamin Y Q Tan, Xin Zhou, Qing Yang, Mayank Dalakoti, Ching-Hui Sia","doi":"10.1097/HJH.0000000000003903","DOIUrl":"10.1097/HJH.0000000000003903","url":null,"abstract":"<p><strong>Introduction: </strong>Glucagon-like peptide-1 receptor agonists are novel medications with proven efficacy in treating type 2 diabetes mellitus, and are increasingly being used for weight loss. They may potentially have benefit in treating metabolic disorders; however, evidence is sparse with regards to treating high blood pressure (BP). We performed a systematic review, meta-analysis and meta-regression investigating the efficacy of GLP-1 RAs in lowering BP in obese or overweight patients.</p><p><strong>Methods: </strong>Three electronic databases (PubMed, EMBASE, and CENTRAL) were systematically searched for randomized controlled trials (RCTs) published from inception to 13 February 2024. Pair-wise meta-analysis and random effects meta-regression models were utilized. Fixed effects meta-analysis was used to unify treatment effects across different GLP-1 RA doses.</p><p><strong>Results: </strong>We included a total of 30 RCTs with a combined population of 37 072 patients. GLP-1 RAs demonstrated a mean systolic BP (SBP) reduction of -3.37 mmHg [95% confidence interval (CI) -3.95 to -2.80] and a mean diastolic BP (DBP) reduction of -1.05 mmHg (95% CI -1.46 to -0.65) compared with placebo. This effect was consistent across subgroups for diabetic status, formulation of GLP-1 RA, follow-up duration and route of administration for both SBP and DBP, with the exception of subgroups investigating exenatide. Meta-regression suggested no significant correlation between BP reduction and baseline characteristics such as age, percentage of male patients, HbA1c, weight, BMI, and percentage of patients with hypertension.</p><p><strong>Conclusion: </strong>Our meta-analysis suggests significant BP reduction benefits from GLP-1 RA use in obese or overweight patients, consistent across diabetic status, duration of treatment, and across route of administration.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"290-300"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502044","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":"Periodontitis accelerates the onset of hypertension in spontaneously hypertensive rats, while the electrical activation of the carotid sinus nerve delays the beginning of the increase in blood pressure.","authors":"Tereza C Buzinari, Jaci A Castania, Sergio L S Salvador, Aline B Ribeiro, Rubens Fazan Junior, Helio C Salgado","doi":"10.1097/HJH.0000000000003906","DOIUrl":"10.1097/HJH.0000000000003906","url":null,"abstract":"<p><strong>Background: </strong>We have previously demonstrated that electrical stimulation of the carotid sinus nerve (CSN) protects the development of periodontitis. In the current study, we evaluated whether periodontitis accelerates the onset of hypertension in spontaneously hypertensive rats (SHR); and whether electrical stimulation of the CSN would delay the onset of hypertension.</p><p><strong>Methods: </strong>Three-week old SHR were implanted with electrodes around the CSN for electrical stimulation for 13 days. Bilateral ligation of the first molar and oral administration of Porphyromonas gingivalis induced periodontitis. The femoral artery of the SHR was cannulated, and 24 h later, in a conscious state, the blood pressure was recorded.</p><p><strong>Results: </strong>Five-week old sham SHR (subjects without electrical stimulation of the CSN) did not demonstrate hypertension. However, when the SHR were submitted to periodontitis they exhibited hypertension at 5 weeks of age. Nevertheless, the stimulation of the CSN prevented the onset of hypertension. Periodontitis promoted alveolar bone loss in SHR; but, electrical stimulation of the CSN prevented this undesirable outcome following the exposure to periodontitis.</p><p><strong>Conclusion: </strong>Periodontitis accelerated the onset of hypertension in SHR; while the electrical stimulation of the CSN delayed the onset of hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"301-307"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502047","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":"Isometric handgrip versus aerobic exercise: a randomized trial evaluating central and ambulatory blood pressure outcomes in older hypertensive participants.","authors":"Sae Young Jae, Eun Sun Yoon, Hyun Jeong Kim, Min Jeong Cho, Jina Choo, Jang-Young Kim, Setor K Kunutsor","doi":"10.1097/HJH.0000000000003919","DOIUrl":"10.1097/HJH.0000000000003919","url":null,"abstract":"<p><strong>Objective: </strong>It remains unclear whether the hemodynamic effects of isometric handgrip exercise (IHG) are comparable to those of aerobic exercise (AE). This study investigated the efficacy of IHG in reducing central and ambulatory blood pressure in older hypertensive participants and compared its effects with AE.</p><p><strong>Methods: </strong>In a three-arm randomized controlled trial, 54 older hypertensive participants (age range: ≥60; mean age: 69 years) underwent 12 weeks of either IHG training ( n  = 17), AE training ( n  = 19), or were part of a no-exercise control group ( n  = 18). IHG participants engaged in bilateral handgrips using a digital device, four times for 2 min each at 30% of maximal voluntary contraction. AE participants undertook brisk walking and cycling exercises at moderate intensity for 30 min, thrice weekly. Baseline and postintervention measurements included resting office, central, and 24-h ambulatory blood pressures.</p><p><strong>Results: </strong>Both IHG and AE interventions led to significant reductions in office and ambulatory systolic blood pressure compared to control group ( P  < 0.05 for both), with no marked difference in the magnitude of systolic blood pressure reductions between the two groups. Notably, the IHG group exhibited greater reductions in office, central, and ambulatory diastolic blood pressure compared to the AE group and control group.</p><p><strong>Conclusion: </strong>While both IHG and AE effectively lowered ambulatory systolic blood pressure, IHG demonstrated superior efficacy in reducing central and ambulatory diastolic blood pressure. Consequently, IHG training presents a promising alternative antihypertensive therapy for hypertensive participants over the age of 60.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"351-358"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621952","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":"Renal denervation - radiofrequency vs. ultrasound: insights from a mixed treatment comparison meta-analysis of randomized sham controlled trials.","authors":"Sripal Bangalore, M Haisum Maqsood, George L Bakris, Sunil V Rao, Franz H Messerli","doi":"10.1097/HJH.0000000000003909","DOIUrl":"10.1097/HJH.0000000000003909","url":null,"abstract":"<p><strong>Background and aims: </strong>Multiple randomized trials have shown that renal denervation (RDN) reduces blood pressure (BP) when compared with sham control but the antihypertensive efficacy of radiofrequency vs. ultrasound-based RDN is uncertain. We aimed to compare the outcomes of radiofrequency RDN (rRDN) and ultrasound RDN (uRDN), when compared with sham in patients with hypertension.</p><p><strong>Methods: </strong>PubMed, EMBASE, and clinicaltrials.gov databases were searched for randomized sham-controlled trials (RCTs) of rRDN or uRDN or for trials of rRDN vs. uRDN. Primary efficacy outcome was 24-h ambulatory SBP. A mixed treatment comparison meta-analysis was performed comparing the efficacy and safety against sham and against each other.</p><p><strong>Results: </strong>Among 13 RCTs that enrolled 2285 hypertensive patients, rRDN reduced 24-h ambulatory SBP [(MD = 2.34 mmHg; 95% confidence interval (95% CI): 0.72-3.95], office SBP (MD = 5.04 mmHg; 95% CI: 2.68-7.40)], and office DBP (MD = 2.95 mmHg; 95% CI: 1.68-4.22) when compared with sham. Similarly, uRDN reduced 24-h ambulatory SBP (MD = 4.74 mmHg; 95% CI: 2.80-6.67), day-time ambulatory SBP (MD = 5.40 mmHg; 95% CI: 3.68-7.13), night-time ambulatory SBP (MD = 3.84 mmHg; 95% CI: 0.02-7.67), and office SBP (3.98 mmHg; 95% CI: 0.78-7.19) when compared with sham. There was significantly greater reduction in 24-h ambulatory SBP (MD = 2.40 mmHg; 95% CI: 0.09-4.71), day-time ambulatory SBP (MD = 4.09 mmHg; 95% CI: 1.61-6.56), and night-time ambulatory SBP (MD = 5.76 mmHg; 95% CI: 0.48-11.0) with uRDN when compared with rRDN. For primary efficacy outcome, uRDN ranked #1, followed by rRDN (#2), and sham (#3).</p><p><strong>Conclusion: </strong>In hypertensive patients, rRDN and uRDN significantly reduced 24-h ambulatory and office SBP when compared with sham control with significantly greater reduction in ambulatory BP with uRDN than with rRDN at 4 months (mean) of follow-up. A large-scale randomized head-to-head trial of rRDN or uRDN is warranted to evaluate if there are differences in efficacy.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"325-335"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502023","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":"Response to comment.","authors":"Richard Kazibwe, Juliana H Namutebi","doi":"10.1097/HJH.0000000000003934","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003934","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 2","pages":"367-368"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921968","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":"The use of loop diuretics in the context of hypertensive disorders of pregnancy: a systematic review and meta-analysis: Erratum.","authors":"","doi":"10.1097/HJH.0000000000003941","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003941","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 2","pages":"369"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921072","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":"Impact of expected blood pressure reduction on patient preferences for pharmaceutical and renal denervation treatment.","authors":"Atul Pathak, Michael A Weber, Christine Poulos, Sidney A Cohen, Vanessa DeBruin, David E Kandzari","doi":"10.1097/HJH.0000000000003872","DOIUrl":"10.1097/HJH.0000000000003872","url":null,"abstract":"<p><strong>Background: </strong>Effective patient-centered care requires an adequate understanding of patient preferences for different therapeutic options. We modelled patient preference for blood pressure (BP) management by pharmaceutical or interventional treatments such as renal denervation in patients with different profiles of uncontrolled hypertension.</p><p><strong>Methods: </strong>Modeling was based on the findings from a previously conducted quantitative discrete choice experiment (DCE). The likelihood of selecting either an interventional treatment option or additional antihypertensive medication option was calculated for three patient profiles that represent the range of patients with hypertension commonly encountered in clinical practice: treatment-naive, patients with uncontrolled BP while on one to three antihypertensive medications, and patients with drug-resistant hypertension. Variables in the preference model were treatment attributes from the DCE study: expected reduction in office SBP with each treatment, duration of treatment effect, risk of reversible drug side effects from drugs, and risk of temporary pain and/or bruising or vascular injury from interventions. Values of the variables were derived from published clinical studies or expert opinion.</p><p><strong>Results: </strong>The model predicted that the likelihood of choosing an intervention over initiating pharmacotherapy was 17.2% for previously untreated patients, 23.7% for patients with moderate hypertension currently on pharmacotherapy, and 41.8% for patients with drug-resistant hypertension. The dominant variable driving preference in these models was the expected BP reduction. Patient preferences for intervention are greater when drug nonadherence or increased SBP reduction at 3 vs. 1 year are included in the model. Baseline BP, drug side effects, or risks of the procedure had little influence on decisions.</p><p><strong>Conclusion: </strong>Modeling using patient preference weights predicts that a substantial minority of patients favor an interventional treatment such as renal denervation over initiation or escalation of medications. Awareness of a patient's interest in device-based versus pharmaceutical strategies should inform the shared decision-making process for hypertension treatment.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"228-235"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348189","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}