Journal of Hypertension最新文献

{"title":"The bidirectional link between left ventricular hypertrophy and chronic kidney disease. A cross lagged analysis.","authors":"Eva Ntounousi, Graziella D'Arrigo, Mercedes Gori, Giovanni Bruno, Francesca Mallamaci, Giovanni Tripepi, Carmine Zoccali","doi":"10.1097/HJH.0000000000004001","DOIUrl":"10.1097/HJH.0000000000004001","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is known to reduce glomerular filtration rate (GFR), while chronic kidney disease (CKD) significantly increases the risk of left ventricular hypertrophy (LVH) and HF. Although these connections have been explored in separate studies, comprehensive research examining the mutual links between CKD and LVH progression is lacking.</p><p><strong>Methods: </strong>Our study investigates the longitudinal relationship between estimated GFR (eGFR) and left ventricular mass index (LVMI) in a cohort of 106 CKD patients across stages G1-5. Using a cross-lagged model, we paired each predictor (eGFR or LVMI) with subsequent outcome measurements, adjusting for previous values to ensure accuracy. Over a three-year follow-up period, we analyzed 257 paired LVMI and eGFR measurements.</p><p><strong>Results: </strong>At baseline, the median eGFR was 54 ml/min/1.73 m 2 , and the LVMI was 134 ± 48 g/m 2 , with a 62% prevalence of LVH. Our adjusted models revealed that a decrease in eGFR by 1 ml/min/1.73 m 2 predicted an increase in LVMI of 1.12 g/m 2 (95% CI: 0.71-1.54, P  < 0.001). In contrast, high LVMI did not predict a reduction in eGFR over time. This analysis highlights a significant risk of LVH worsening due to GFR loss, while the reverse risk does not achieve statistical significance.</p><p><strong>Conclusions: </strong>Although these observational analyses cannot establish causality, they suggest that the risk of cardiomyopathy driven by kidney disease in stable CKD patients may be more substantial than the risk of CKD progression driven by heart disease. This insight underscores the importance of monitoring kidney function to manage cardiovascular risk in CKD patients.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"986-992"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624947","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 effects of empagliflozin on systemic haemodynamic function: three randomized, placebo-controlled trials.","authors":"Steffen F Nielsen, Camilla L Duus, Niels Henrik Buus, Jesper N Bech, Frank H Mose","doi":"10.1097/HJH.0000000000004007","DOIUrl":"10.1097/HJH.0000000000004007","url":null,"abstract":"<p><strong>Background: </strong>Sodium glucose cotransporter 2 inhibitors lower blood pressure. The underlying mechanisms are multifactorial and include effects on vascular function. We examined the systemic hemodynamic effects of empagliflozin in patients with type 2 diabetes mellitus (DM2) with and without chronic kidney disease (CKD) and in patients with nondiabetic CKD.</p><p><strong>Methods: </strong>Three double-blinded, randomized, placebo-controlled cross-over trials, including patients with DM2 and preserved renal function ( n  = 16), DM2 and CKD ( n  = 17) and nondiabetic CKD ( n  = 16). Participants were randomized to 4 weeks of empagliflozin 10 mg or placebo and crossed over after a 2-week washout. We measured brachial and central 24-h ambulatory blood pressure (ABP), pulse wave velocity (PWV), augmentation index (AIx@75), markers of nitric oxide and erythrocyte sodium sensitivity (ESS), a marker of endothelial glycocalyx function.</p><p><strong>Results: </strong>Empagliflozin reduced PWV [-0.16 m/s, 95% confidence interval (95% CI): -0.26; -0.06, P  = 0.002], AIx@75 (-2.17%, 95% CI: -3.31; -1.02, P  < 0.001) and brachial and central ABP in the combined study population ( n  = 49). Changes in PWV and AIx@75 correlated to changes in systolic brachial ABP. Markers of nitric oxide did not increase, but empagliflozin decreased ESS, which was correlated to an increase in haematocrit.</p><p><strong>Conclusion: </strong>Empagliflozin decreased arterial stiffness, mediated partly by a decrease in brachial ABP. We found no increase in nitric oxide activity, but ESS decreased. While this may be explained partly by a change in haematocrit, it could indicate an improvement in endothelial glycocalyx function.</p><p><strong>Trial registration: </strong>EU Clinical Trials Register 2019-004303-12, 2019-004447-80 and 2019-004467-50.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1021-1029"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742135","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":"Low flow state masks true arterial stiffness on pulse wave analysis in patients with severe aortic stenosis.","authors":"Ning Song, Sara L Hungerford, Mayooran Namasivayam, Andrew Jabbour, Christopher S Hayward, David W M Muller, Audrey I Adji","doi":"10.1097/HJH.0000000000004064","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004064","url":null,"abstract":"<p><strong>Background: </strong>Aortic stenosis is a common valvular disorder that shares pathophysiological principles with age-associated elevated arterial stiffness. Flow attenuation from valvular obstruction in aortic stenosis may lead to under-estimation of true arterial stiffness, particularly in aortic stenosis patients with reduced stroke volume.</p><p><strong>Methods: </strong>Severe aortic stenosis patients were divided into high mean transvalvular gradient (HG, ≥40 mmHg) and low mean transvalvular gradient (LG, <40 mmHg) and compared with elderly controls without aortic stenosis. Aortic pressures were obtained from radial arterial tonometry calibrated to brachial cuff pressures simultaneously with aortic flows acquired via cardiac magnetic resonance phase contrast imaging. Pulse wave analysis was performed and pulsatile arterial load indices calculated using frequency domain analysis.</p><p><strong>Results: </strong>We analysed 58 patients, with 21, 16 and 21 patients in the high gradient, low gradient and control groups, respectively. Aortic stenosis patients had higher augmentation indices (high gradient 40 ± 8%; low gradient 38 ± 7%; control 32 ± 9%, P < 0.01) despite lower mean arterial pressure (high gradient 91 ± 22 mmHg; low gradient 94 ± 23 mmHg; control 109 ± 17 mmHg, P =0.02). Cardiac output, systemic vascular resistance and aortic characteristic impedance were comparable. The high gradient group had a significantly higher stroke volume index (high gradient 39 ± 8 ml/m2; low gradient 33 ± 7 ml/m2; control 34 ± 7 ml/m2, P = 0.02), but stroke volume index was positive correlated with augmentation index only in the low gradient group (R = 0.57, P = 0.02).</p><p><strong>Conclusion: </strong>In patients with low gradient aortic stenosis, smaller stroke volume index is associated with lower measured arterial stiffness by augmentation index on pulse wave analysis, suggesting that ventriculo-valvulo-arterial uncoupling due to elevated arterial stiffness may be more pronouncedly under-estimated in patients low-flow, low-gradient aortic stenosis.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284979","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 importance of experience: insights into optimal home-blood pressure monitoring regimens from the TASMINH4 Trial.","authors":"Emily C Morris, Katherine L Tucker, Richard J McManus, Richard J Stevens","doi":"10.1097/HJH.0000000000004062","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004062","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates how prior home blood pressure monitoring (HBPM) experience affects blood pressure variability and evaluates if reduced HBPM regimens could be recommended for experienced patients.</p><p><strong>Methods: </strong>This posthoc analysis of the TASMINH4 trial included self-monitored blood pressure (BP) data from 225 patients. The standard deviation of systolic BP recordings was calculated for each patient-week to assess how BP variability changes with HBPM duration. A subgroup of 84 patients, who submitted at least 1 reading a day for 7 days at months 1, 3, and 6, was analysed to assess the impact of reduced HBPM regimens on BP estimates.</p><p><strong>Results: </strong>Day 1 readings were significantly higher than day 2-7 in the first 3 months of HBPM: 1.1 (95% CI 1.8, 0.4) day 1 vs. day 2. This effect diminished after 6 months: 1.0 (95% CI -0.8, 2.8) day 1 vs. 2. Long term monitoring significantly reduced intra-week BP variability, with the standard deviation of systolic BP recordings within each patient-week significantly reduced after 6 months. After 6 months of HBPM, the inclusion of day 1 readings or use of an abbreviated monitoring regimen had a reduced impact on estimates of mean systolic and diastolic blood pressure.</p><p><strong>Conclusions: </strong>Long-term HBPM reduces intra-week BP variability, making day 1 readings insignificantly raised after 6 months of HBPM. This provides rationale for different HBPM recommendations: longer regimes, excluding day one readings, for diagnosis and short-term monitoring; and abbreviated regimes including day 1 for longer term monitoring in those with HBPM experience.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127846","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 cardiorespiratory fitness and pediatric primary hypertension: a case-control study in China.","authors":"Tingjuan Lin, Wenqing Jiang, Yao Lin, Mingming Zhang, Tong Zheng, He Jiang, Baosheng Liang, Yan Liu, Yu Chen, Qin Zhang, Lin Shi","doi":"10.1097/HJH.0000000000004036","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004036","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the association between cardiorespiratory fitness (CRF) and the risk of primary hypertension in children and adolescents, and to explore the relationship between CRF and hemodynamic parameters.</p><p><strong>Methods: </strong>In this single-center case-control study, 972 participants aged 10-17 years (352 hypertension cases, 620 controls) were included. CRF was quantified as peak oxygen uptake (VO2peak) using a validated equation derived from treadmill tests. Logistic regression models, restricted cubic splines, and subgroup analyses were employed to assess CRF-hypertension associations, adjusted for age, sex, height, and overweight/obesity. Multivariate linear regression evaluated correlations between CRF and blood pressure or heart rate parameters.</p><p><strong>Results: </strong>After adjustment, each 5 ml/kg/min increment in CRF was associated with a 30% reduction in hypertension risk [odds ratio (OR) 0.70, 95% confidence interval (95% CI) 0.63-0.78, P < 0.001]. Participants with CRF less than 44.7 ml/kg/min exhibited a 3.35-fold higher hypertension risk than those with CRF at least 44.7 ml/kg/min (OR 3.35, 95% CI 2.21-5.16, P < 0.001). Subgroup analyses confirmed consistency across age, sex, height, and BMI status (P for interaction > 0.05). Notably, overweight/obese individuals showed a 35% risk reduction per 5 ml/kg/min CRF improvement (OR 0.65, 95% CI 0.57-0.74). CRF was inversely correlated with systolic, diastolic, and mean arterial blood pressure, resting and peak heart rate, peak SBP/DBP, and rate-pressure product (all P < 0.05).</p><p><strong>Conclusion: </strong>Higher CRF is independently associated with reduced primary hypertension risk in children and adolescents, highlighting its role as a modifiable protective factor, particularly among overweight/obese youth. These findings support CRF-enhancing interventions as a preventive strategy against pediatric hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266424","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":"Correlation of the Mediterranean-Dietary Approaches to Stop Hypertension diet vs. ultra-processed diet with health outcomes in type 2 diabetes and hypertension: new insights from a 12-month interventional study.","authors":"Tatiana Palotta Minari, Veridiana Vera de Rosso, Carolina Freitas Manzano, Marcelo Jamil Humsi, Louise Buonalumi Tácito Yugar, Luis Gustavo Sedenho-Prado, Tatiane de Azevedo Rubio, Lúcia Helena Bonalumi Tácito, Antônio Carlos Pires, José Fernando Vilela-Martin, Luciana Neves Cosenso-Martin, Juan Carlos Yugar-Toledo, Heitor Moreno, Luciana Pellegrini Pisani","doi":"10.1097/HJH.0000000000004061","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004061","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;There is ongoing debate about the optimal macronutrient and micronutrient proportions for treating type 2 diabetes (T2D) and hypertension. The objective of this study was to evaluate the dietary composition of patients participating in a 12-month interventional study with follow-up. Additionally, it aimed to evaluate the interactions and correlations between diet components and anthropometric markers, laboratory markers, and blood pressure (BP). Finally, perform a qualitative analysis of daily and postmeal satiety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This experimental, analytical, and correlational study is a quaternary evaluation within a recently published longitudinal research. Eighty-four participants were divided into two groups: intervention: followed a Mediterranean-DASH diet for 12 months with follow-up at 15 months; control: no dietary changes. Parametric variables were compared using two-way ANOVA and Tukey post hoc test. Nonparametric variables were compared using Kruskal-Wallis with Dwass-Steel-Critchlow-Fligner post hoc test and Friedman with Durbin-Conover post hoc test. Parametric data were represented as mean ± standard deviation, nonparametric as median ± interquartile range. Linear regression was used for interaction/relation analysis, and Pearson test for correlation. Significance was P less than 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Initially, both groups consumed diets high in ultra-processed foods, rich in refined carbohydrates, saturated fats, and sodium. At the 12th visit and follow-up, the intervention group showed substantial improvement in diet quality and dietary requirements (P &lt; 0.05). The control group maintained or worsened their diet quality (P &lt; 0.05). At first, both groups reported high hunger and low satiety. By the 12th month, the intervention group showed significant improvements, with 88.6% reporting postmeal fullness and 75% experiencing daily satiety. Significant positive and negative correlations (P &lt; 0.05) were observed in both groups. In the control group, low-density lipoprotein cholesterol (LDL-C) was correlated with trans fats and proteins; high-density lipoprotein cholesterol (HDL-C) with polyunsaturated fats; total cholesterol (TC) with proteins and monounsaturated fats; and glycated hemoglobin (HbA1c) with fibers. In the intervention group, BMI was correlated with carbohydrates; HbA1c with total fats; LDL-C with carbohydrates; glucose with proteins; TC with total fats and carbohydrates; HDL-C with total fats, polyunsaturated fats, and saturated fats; glucose with monounsaturated fats (P &lt; 0.05). In the intervention group, BP, heart rate, plasma, and urinary sodium levels significantly improved over time (P &lt; 0.05). However, no strong correlations between sodium intake and these markers were observed (P &gt; 0.05). In contrast, the control group showed no significant changes in BP, heart rate, plasma, or urinary sodium levels over time (P &gt; 0.05), nor were there an","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127841","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":"Nocturnal blood pressure: pathophysiology, measurement and clinical implications. position paper of the European Society of Hypertension.","authors":"Gianfranco Parati, Martino F Pengo, Alberto Avolio, Michel Azizi, Tomas Lucca Bothe, Michel Burnier, Francesco Paolo Cappuccio, Alejandro De La Sierra, Cristiano Fava, Mariela M Gironacci, Satoshi Hoshide, Kazuomi Kario, Anastasios Kollias, Carolina Lombardi, Giuseppe Maiolino, Simona Maule, Krzysztof Narkiewicz, Takayoshi Ohkubo, Paolo Palatini, Jean Luis Pepin, Pantelis Sarafidis, Aletta Elisabeth Schutte, Alessandro Silvani, George Stergiou, Paolo Verdecchia, Giuseppe Mancia, Grzegorz Bilo","doi":"10.1097/HJH.0000000000004053","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004053","url":null,"abstract":"<p><p>Interest in the pathophysiology, measurement, and clinical implications of nocturnal blood pressure (BP) has significantly increased due to its strong association with cardiovascular risk, and its importance was recognized by the 2023 European Society of Hypertension (ESH) guidelines. Nocturnal BP regulation is complex and multifactorial, involving sleep-wake cycle, circadian rhythms, autonomic nervous system, renin-angiotensin-aldosterone system, and renal mechanisms. 24-h ambulatory blood pressure monitoring is currently the reference method for nocturnal BP assessment. Home BP monitoring, with specially designed, validated devices with nocturnal BP measuring function, may also be used, while new cuffless and wearable technologies hold great potential but require further validation. Nocturnal BP phenotypes of clinical interest include nocturnal hypertension, increased nocturnal BP variability and altered day-night BP fluctuations. Among those, isolated nocturnal hypertension may be considered a type of masked hypertension. BP variability has prognostic relevance, as do the day-night BP changes, i.e. the nocturnal BP \"dipping\". Nocturnal hypertension and nondipping are particularly prevalent in individuals with autonomic neuropathies, sleep disorders (e.g., obstructive sleep apnoea), kidney disease, and metabolic or endocrine disorders, and are linked to hypertension mediated organ damage and cardiovascular risk. Therapeutic strategies targeting nocturnal BP remain debated. Chronotherapy (evening dosing of antihypertensives) has shown inconsistent results in clinical trials. Renal denervation and treatment of sleep-related breathing disorders may lower nocturnal BP and improve sleep quality. More research is needed to further clarify pathophysiology, measurement, therapeutic interventions, and overall management of nocturnal hypertension, issues on which this ESH position paper offers an in-depth review.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension in children with intellectual disabilities: a population not to be overseen.","authors":"Justyna Wyszyńska, Edyta Łuszczki, Tomas Seeman, Giacomo D Simonetti, Olena Nyankovska, Małgorzata Wójcik, Agnieszka Kozioł-Kozakowska, Aliki Peletidi, Artur Mazur, Julio Alvarez-Pitti, Empar Lurbe","doi":"10.1097/HJH.0000000000004052","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004052","url":null,"abstract":"<p><p>Hypertension (HTN) is a significant public health concern affecting individuals across all age groups, including those with and without disabilities. Among children and adolescents, particularly those with intellectual disabilities, the risk of HTN is heightened due to factors such as obesity, low physical activity, and comorbid conditions. Regular blood pressure (BP) monitoring is essential, considering the challenges in measurement accuracy among children with intellectual disabilities. Beyond traditional lifestyle modifications, individualized dietary interventions and structured physical activity programs play a fundamental role in HTN prevention and management. Additionally, optimizing sleep quality and addressing comorbidities are essential for improving long-term health outcomes. The updated recommendations emphasize a broader specialist involvement, including endocrinologists, nephrologists, cardiologists, and rehabilitation specialists, to ensure comprehensive care. The integration of these approaches, along with appropriate pharmacological strategies whenever necessary, is crucial for achieving health benefit. This article provides practical guidance for primary care providers, specialists, and caregivers, advocating for a collaborative, patient-centered approach to reducing cardiovascular risks and enhancing the quality of life for children with intellectual disabilities.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150769","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":"Factor IX and incident hypertension in Black and White adults: the REasons for Geographic and Racial Differences in Stroke cohort.","authors":"Eric G Stoutenburg, Maria C Bravo, Virginia J Howard, Suzanne E Judd, D Leann Long, Timothy B Plante","doi":"10.1097/HJH.0000000000004045","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004045","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a cardiovascular disease risk factor disproportionately affecting Black adults. Certain biomarkers of thrombosis and inflammation are associated with a greater risk of hypertension. Factor IX is a marker of thrombosis; Black adults have higher levels than others. Whether factor IX correlates with incident hypertension risk or explains some of the disproportionate burden faced by Black adults, is not known.</p><p><strong>Methods: </strong>REasons for Geographic and Racial Differences in Stroke (REGARDS) recruited 30 239 Black and White adults from the contiguous US in 2003-2007 (Visit 1) and had repeat assessment in 2013-2016 (Visit 2). Factor IX was measured in Visit 1 samples in a sex-race stratified sample of 4400 participants that attended both visits. Modified Poisson regression estimated adjusted risk ratios (RR) for incident hypertension at Visit 2 by factor IX tertiles. Inverse odds ratio weighting estimated the proportion of the excess burden of incident hypertension in Black adults due to factor IX levels.</p><p><strong>Results: </strong>Among 1824 participants (55% female and 24% Black race), 36% developed hypertension. The fully adjusted RR for the third vs. first tertile was 1.21; 95% confidence interval (CI) 1.03-1.43, and there was a significant linear trend across tertiles (P < 0.001). Factor IX did not mediate excess hypertension risk among Black adults in adjusted models.</p><p><strong>Conclusions: </strong>In this prospective study of Black and White adults without prevalent hypertension, higher factor IX was associated with a greater risk of incident hypertension. This risk may relate to adverse thromboinflammation among persons in the 2nd and 3rd tertiles of factor IX.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970115","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":"Breaking down resistance: novel aldosterone synthase inhibitors in the management of resistant hypertension.","authors":"Chai Eddison Chung Hung, Cyril Kocherry, Jacob George","doi":"10.1097/HJH.0000000000004055","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004055","url":null,"abstract":"<p><p>This review aims to evaluate the impact of novel aldosterone synthase inhibitors, the first new class of antihypertensives in more than 20 years, on the management of resistant hypertension. We highlight the problem of resistant hypertension in clinical practice and describe the challenging history and development of aldosterone synthase inhibitors. The review highlights clinical trial evidence to-date for all agents in this class, with a key focus on the two most mature agents baxdrostat and lorundrostat which are currently in pivotal Phase 3 trials. Both agents have demonstrated significant dose-dependent reductions in blood pressure, particularly in patients with resistant hypertension and crucially, with a minimal impact on cortisol levels. They have also shown promise with marked blood pressure reductions in patients with varying physiological profiles and few adverse events at optimised doses. However, as would be expected, both drugs are associated with increases in serum potassium levels, necessitating careful monitoring.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020931","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}