Journal of Hypertension最新文献

{"title":"Blood-brain barrier disruption in response to blood pressure changes in adults with hypertension: a serial MRI study.","authors":"Esther Janssen, Joost J A de Jong, Esmée Verburgt, Annemieke Ter Telgte, Daniëlle T N A van den Berg, Marnix C Maas, Frederick J A Meijer, Anil M Tuladhar, Niels P Riksen, Jaap Deinum, Walter H Backes, Frank-Erik de Leeuw","doi":"10.1097/HJH.0000000000004444","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004444","url":null,"abstract":"<p><strong>Background: </strong>Loss of blood-brain barrier (BBB) integrity is observed in patients with hypertension and is hypothesized to contribute to cerebral small vessel disease (SVD) pathogenesis. Blood pressure increase and decrease within individuals and the effects on BBB integrity have never been examined.</p><p><strong>Objectives: </strong>To examine BBB leakage in middle-aged patients with hypertension following subsequent blood pressure increase and decrease.</p><p><strong>Methods: </strong>The Hyperintense study included hypertensive adults who temporarily discontinued antihypertensive medication for diagnostic purposes. MRI was done at three timepoints: before medication withdrawal (visit 1), during withdrawal (visit 2) and after medication restart (visit 3). BBB integrity was measured with 3T dynamic contrast-enhanced (DCE)-MRI. We assessed leakage rate Ki [min-1] and blood plasma volume Vp. Linear regression was used to examine association between changes in blood pressure and BBB leakage.</p><p><strong>Results: </strong>Fourteen patients with hypertension (mean age 48.2 ± 4.5 years; 36% female) were included. After medication withdrawal, blood pressure increased in 11/14 participants (79%). Increase in blood pressure between visit 1 and visit 2 was associated with increased Ki in white (WM) (β = 0.683, P = 0.007) and grey matter (GM) (β = 0.587, P = 0.027) and Vp in the GM (β = 0.666, P = 0.009). Following medication restart, blood pressure decreased in seven participants, with Ki decreasing in four of them. There was no association between decrease in blood pressure and Ki or Vp between visit 2 and visit 3.</p><p><strong>Conclusions: </strong>Blood pressure increase was associated with increased BBB leakage. Reduction in BBB leakage following medication restart was observed in most, but not all participants. This suggests that BBB leakage is dynamic and influenced by blood pressure.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976329","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":"Continual cuffless blood pressure monitoring in children: agreement and feasibility compared with ambulatory blood pressure monitoring.","authors":"Michal Huml, Alexandra Kotková, Tereza Fremuthová, Karel Fiklík, Renata Pomahačová, Stanislav Kormunda, Josef Sýkora, Jiří Fremuth","doi":"10.1097/HJH.0000000000004445","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004445","url":null,"abstract":"<p><strong>Background: </strong>Cuffless wearable technologies enable continual blood pressure (BP) monitoring and may improve tolerability compared with conventional cuff-based methods. Pediatric data comparing cuffless devices with ambulatory blood pressure monitoring (ABPM) remain limited.</p><p><strong>Methods: </strong>In this prospective observational study, children with well controlled type 1 diabetes mellitus and normal office BP underwent simultaneous 24-h monitoring using a wrist-worn cuffless optical device and conventional ABPM. Between-method differences were assessed for averaged 24-h, daytime, and nighttime systolic and diastolic BP. Equivalence was evaluated using the two one-sided tests procedure with a prespecified exploratory ± 10 mmHg margin, whereas individual-level agreement was assessed using Bland-Altman analysis.</p><p><strong>Results: </strong>Twenty-one participants were included (mean age 14.7 ± 2.6 years). Mean differences (Aktiia - ABPM) were -4.5 mmHg for 24-h systolic BP and -0.8 mmHg for 24-h diastolic BP. The 90% confidence intervals were fully contained within the ±10 mmHg margin for 24-h and nighttime systolic BP and for diastolic BP across all periods, but not for daytime systolic BP. Bland-Altman analysis showed modest mean bias but wide limits of agreement, particularly for systolic BP. Nocturnal systolic and diastolic BP dipping was attenuated with cuffless monitoring.</p><p><strong>Conclusions: </strong>In this selected pediatric cohort, continual cuffless BP monitoring was feasible and showed group-level comparability with ABPM for averaged 24-h BP values. However, it should not be considered interchangeable with ABPM for individual clinical decisions or assessment of nocturnal dipping. Larger studies in more diverse pediatric populations are required before broader clinical implementation.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944991","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 Reactivity and Urinary Abnormalities in Young Athletes.","authors":"Elisa Lodi, Maria Luisa Poli, Adolfo Perrotta, Gustavo Savino, Emanuela Paoloni, Shaniko Kaleci, Maria Grazia Modena","doi":"10.1097/HJH.0000000000004400","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004400","url":null,"abstract":"<p><strong>Background: </strong>Urinary abnormalities such as hematuria and proteinuria are occasionally detected in pediatric athletes and are commonly attributed to transient exercise-induced renal stress. However, these findings may also reflect early alterations in cardiovascular regulation, particularly in blood pressure (BP) responses to physical effort.</p><p><strong>Objective: </strong>To evaluate the prevalence of urinary abnormalities in young athletes and investigate their association with cardiovascular parameters, with particular focus on hemodynamic response to exercise.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 861 pediatric athletes (mean age 13.7 ± 2.1 years) undergoing mandatory pre-participation sports screening. Participants were classified according to the presence (n = 80) or absence (n = 781) of urinary abnormalities. Demographic characteristics, anthropometric measures, urine chemistry, blood pressure and heart rate at rest and after exercise, and echocardiographic findings were compared between groups.</p><p><strong>Results: </strong>Urinary abnormalities were detected in 9.3% of athletes. Hematuria and proteinuria were significantly more frequent in this group (P < 0.001). No differences were observed in age, sex distribution, body mass index, or type of sport practiced. However, athletes with urinary abnormalities showed higher resting diastolic blood pressure (64.9 ± 8.5 vs. 62.7 ± 6.5 mmHg, P = 0.005) and a greater increase in diastolic pressure after exercise both in absolute (ΔDBP: 5.8 ± 10.5 vs. 3.1 ± 9.4 mmHg, P = 0.017) and relative terms (ΔDBP%: 7.8% vs. 4.3%, P = 0.045). No significant differences were observed in heart rate dynamics or echocardiographic findings.</p><p><strong>Conclusions: </strong>Pediatric athletes with urinary abnormalities exhibited a modest but consistent increase in diastolic BP reactivity to exercise. These findings suggest a modest association between urinary findings and post-exercise hemodynamic adaptation, supporting the integration of cardiovascular assessment into the interpretation of urinary screening results in young athletes.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945049","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 the new 2024 ESC blood pressure classification in a low-risk cohort: the 70 mmhg diastolic threshold may reduce risk discrimination in primary prevention.","authors":"Maryne Lepoittevin, Pierre Bauvin, Alaedine Benani, Philippe Attias, Ph Gabriel Steg, Emmanuelle Vidal-Petiot, Sylvain Bodard","doi":"10.1097/HJH.0000000000004434","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004434","url":null,"abstract":"<p><p>In 2024, the European Society of Cardiology (ESC) hypertension guidelines introduced an \"elevated blood pressure\" category (120-139 and/or 70-89 mmHg), lowering the diastolic threshold from 85 to 70 mmHg. Its relevance for cardiovascular risk stratification in low-risk primary prevention remains uncertain. We conducted a cross-sectional study of 1394 adults undergoing standardized preventive health assessment in France, with office blood pressure (BP) measured using a validated oscillometric device. Participants were classified by ESC/ESH 2018 and ESC 2024 definitions. We quantified category shifts and compared the clinical, lifestyle and biological profile of individuals reclassified from 2018 optimal to 2024 elevated on the basis of diastolic BP ≥70 mmHg (systolic BP < 120 mmHg) vs. those remaining nonelevated. SCORE2, available in 61% of participants, was used as a supporting risk estimate. ESC 2024 classified 10.0% as nonelevated, 64.2% as elevated and 25.8% as hypertensive; 70% of previously \"optimal\" individuals became \"elevated.\" Compared with nonelevated peers, the diastolic-only reclassified group differed only in age (45.5 vs. 42.7 years; P = 0.007), with no difference in sex, body mass index, lifestyle, cardiovascular history or biomarkers. Their slightly higher SCORE2 was attributable to higher systolic BP and age, and was no longer significant after adjustment for systolic BP. By contrast, individuals reclassified from normal to elevated had a less favorable cardiometabolic profile. Lowering the diastolic threshold to 70 mmHg produced substantial reclassification but did not identify an independent higher-risk phenotype when systolic BP remained < 120 mmHg, questioning the relevance of such a low diastolic threshold for elevated BP in the new ESC 2024 classification. Prospective outcome studies are needed.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891928","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":"Prognostic significance of invasive central and peripheral blood pressures for cardiovascular events and mortality.","authors":"Giacomo Pucci, James E Sharman, Riccardo Alcidi, Emanuele M Perotti, Chiara Giacinti, Lucrezia Mattei, Andrea Scarpignato, Martina Sordi, Alessio Arrivi","doi":"10.1097/HJH.0000000000004428","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004428","url":null,"abstract":"<p><strong>Background: </strong>High blood pressure (BP) is the leading modifiable risk factor for cardiovascular disease (CVD) and mortality. The prognostic relevance of invasive central versus peripheral BP for predicting major adverse CVD events (MACEs) remains unexplored. This exploratory study examined the prognostic associations of invasive central and peripheral BP measurement in a cohort of older patients with higher CVD risk.</p><p><strong>Methods: </strong>In 238 patients undergoing elective coronary angiography (mean age 69 ± 11 years, 72% males), invasive aortic and brachial BP were measured sequentially. Patients were followed for 37 ± 23 months for MACEs, defined as a composite of CVD death, nonfatal myocardial infarction or stroke, hospitalization for unstable angina or heart failure.</p><p><strong>Results: </strong>Both aortic and brachial invasive pulse pressures (PP) were independently associated with MACEs [adjusted hazard ratio (aHR) per 10 mmHg increase 1.11, 95% CI 1.01-1.22, P = 0.03, and 1.10, 95% CI 1.01-1.21, P = 0.04, respectively]. Associations of aortic [aHR 1.08, 95% CI 0.99-1.17, P = 0.07] and brachial (aHR 1.07, 95% CI 0.98-1.17, P = 0.13] systolic BPs were borderline. Differences in receiver operating characteristic performance between aortic and brachial PPs (area under the curve difference = 0.02) were not significant. Optimal thresholds for brachial PP to predict MACEs were 10 mmHg higher than aortic PP.</p><p><strong>Conclusions: </strong>In this exploratory cohort of older, higher-risk patients, invasive aortic and brachial PPs showed broadly similar associations with MACEs. Although numerically different, aortic PP appears to offer negligible incremental prognostic value beyond brachial PP, suggesting that measurement at either site would be clinically valuable. These findings warrant confirmation in adequately powered studies.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912580","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":"Pharmacometabolomics of treatment response to antihypertensive drugs: a systematic review.","authors":"Elahe Zare Borzeshi, Merys Valdez, Alida Kindt, Banafsheh Arshi, Elham Memarian, Thomas Hankemeier, Dipak Kotecha, Rick Grobbee, Jonathan E Knikman","doi":"10.1097/HJH.0000000000004355","DOIUrl":"10.1097/HJH.0000000000004355","url":null,"abstract":"<p><p>Hypertension remains a prevalent, modifiable risk factor for cardiovascular disease, with many patients failing to achieve optimal blood pressure (BP) control despite existing therapies. Pharmacometabolomics offers promise by identifying metabolic biomarkers linked to drug response and holds potential for individualizing antihypertensive treatment. We conducted a systematic review of studies from 2013 to 2023, screening 2577 articles and including five that investigated metabolomics-based biomarkers for antihypertensive drug response in cases of primary hypertension. In total, 46 metabolites were significantly associated with BP responses to diuretics, beta-blockers, and ACE inhibitors or angiotensin receptor blockers. Key predictive metabolites included arachidonic acid, sphingosine-1-phosphate, 2-oxoglutarate, and arachidonoyl-carnitine, affecting responses across fatty acid metabolism, sphingolipid metabolism, the TCA cycle, and amino acid metabolism. This review highlights the potential of pharmacometabolomics to uncover metabolites and pathways associated with individual BP response to antihypertensive drugs. Further validation in diverse populations, drug classes, and combination treatments is needed.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1477-1486"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277641","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 between orthostatic blood pressure change and masked and white coat hypertension: the Nagahama study.","authors":"Yasuharu Tabara, Takeshi Matsumoto, Kimihiko Murase, Takahisa Kawaguchi, Tomoko Wakamura, Toyohiro Hirai, Kazuo Chin, Fumihiko Matsuda","doi":"10.1097/HJH.0000000000004366","DOIUrl":"10.1097/HJH.0000000000004366","url":null,"abstract":"<p><strong>Background: </strong>Exaggerated blood pressure (BP) response to orthostatic stimuli is indicative of cardiovascular frailty and may be associated with masked and white coat hypertension, which are BP abnormalities associated with cardiovascular outcomes. We aimed to clarify this possible association in a cross-sectional analysis of a large general population.</p><p><strong>Methods: </strong>We enrolled 7618 community residents (mean age: 57.7 years). Orthostatic BP change was calculated as the difference between systolic BP measured in a seated position and at 3 min after standing. Orthostatic hypertension and hypotension were defined as >20 mmHg increase or decrease in systolic BP, respectively. Masked and white coat hypertension were defined based on office and home morning BP measurements.</p><p><strong>Results: </strong>The frequency of orthostatic hypotension and hypertension was 1.8% and 1.6%, respectively. A significant association was observed between orthostatic BP change and office-to-home BP differences, that is, the greater the increase in orthostatic BP, the higher the home BP than the office BP. The association between orthostatic hypertension and masked hypertension (crude odds ratio: 3.15; P  < 0.001) remained significant even after adjusting for potential covariates, including office seated BP. In addition, orthostatic hypotension was independently associated with white coat hypertension (crude odds ratio: 2.14; P  = 0.002). Orthostatic BP change measured at 3 min showed a clearer association with masked and white coat hypertension than that measured at 1 min.</p><p><strong>Conclusion: </strong>We identified a physiological association between exaggerated postural BP variability and office-to-home BP differences, which were previously considered unrelated.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1539-1546"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211469","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 the letter: \"methodological inconsistencies and nomenclature errors in 'arterial hypertension-attributable mortality in Europe, 2012-2021\"'.","authors":"Marco Zuin","doi":"10.1097/HJH.0000000000004382","DOIUrl":"10.1097/HJH.0000000000004382","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 9","pages":"1660-1662"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669727","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":"Gray zone of hypertension thresholds values can be overcome by individualized symptom-oriented approaches.","authors":"Ertan Yetkin, Hasan Atmaca, Dogaç Çağlar Gürbüz, Kenan Yalta, Mustafa Kemal Erol","doi":"10.1097/HJH.0000000000004383","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004383","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"44 9","pages":"1664-1665"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669802","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":"Genus-level oral microbiome composition and Dietary Approaches to Stop Hypertension dietary adherence in relation to hypertension.","authors":"Tongzhou Xu, Jie Xing, Xin Lin, Yaning Yang, TingSong Yang, Xu Steven Xu, Min Yuan","doi":"10.1097/HJH.0000000000004377","DOIUrl":"10.1097/HJH.0000000000004377","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HTN) remains a leading global health burden and a key risk factor for cardiovascular disease. While the Dietary Approaches to Stop Hypertension (DASH) diet is an established strategy for blood pressure control, the interplay between dietary patterns and the oral microbiome in the etiology of HTN is not well understood.</p><p><strong>Objective: </strong>To investigate the independent and joint associations of genus-level oral microbiome composition and adherence to the DASH diet with hypertension in a nationally representative sample of US adults.</p><p><strong>Methods: </strong>We analyzed data from the 2009-2010 and 2011-2012 National Health and Nutrition Examination Survey (NHANES), including 5371 adults with complete oral microbiome, dietary, blood pressure, and covariate data. Genus-level oral microbiome profiles were derived from oral rinse samples using 16S rRNA sequencing and transformed with the centered log-ratio method. DASH adherence was assessed from 24-h dietary recalls using a validated score. Hypertension was defined as self-reported diagnosis, antihypertensive medication use, or measured blood pressure meeting 2017 American College of Cardiology/American Heart Association (ACC/AHA) criteria (systolic ≥130 mmHg or diastolic ≥80 mmHg). Analyses employed a multistage design: differential abundance testing to identify hypertension-associated genera; survey-weighted multivariable logistic regression to examine independent and joint associations, adjusting for demographic, lifestyle, and clinical covariates; subgroup analyses by sex, age, and microbial characteristics; and sensitivity analyses to assess robustness.</p><p><strong>Results: </strong>Greater adherence to the DASH diet was associated with lower odds of hypertension [high vs. low tertile odds ratio (OR) ≈0.62; P  < 0.005]. Several oral bacterial genera - Actinomyces , Rothia , Lactobacillus , and Veillonella - showed independent associations with increased hypertension risk (OR range: 1.302-1.468; P  < 0.05). Higher Faith's Phylogenetic Diversity was inversely associated with hypertension (OR = 0.742; P  = 0.037). Stratified analyses suggested effect modification: the protective DASH-hypertension association was strongest among individuals with low Lactobacillus abundance and intermediate microbial diversity and Rothia abundance, more pronounced in women, and attenuated in adults aged at least 60 years. Sensitivity analyses confirmed these patterns, highlighting the consistent risk associated with Actinomyces and the stability of joint DASH-microbiome associations.</p><p><strong>Conclusion: </strong>Genus-level oral microbiome composition and DASH dietary adherence were independently and jointly associated with hypertension risk. These results support a potential oral-dietary axis in cardiovascular risk and underscore the need for integrated microbiome-dietary approaches to hypertension prevention.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1585-1593"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211472","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}