Journal of Hypertension最新文献

{"title":"Arterial spin labeling MRI in assessing cerebral blood flow changes due to hypertension: a systematic review.","authors":"Sathya Sabina Muthu, Suresh Sukumar, Rajagopal Kadavigere, Shivashankar K N, K Vaishali, Ramesh Babu M G, Hari Prakash Palaniswamy, Abhimanyu Pradhan, Winniecia Dkhar, Nitika C Panakkal, Sneha Ravichandran, Dilip Shettigar, Poovitha Shruthi Paramashiva","doi":"10.1097/HJH.0000000000004150","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004150","url":null,"abstract":"<p><p>Hypertension is a significant risk factor for cerebrovascular diseases, affecting cerebral blood flow (CBF) and brain health. Reduced CBF in hypertensive individuals is linked to cognitive decline and neurodegenerative diseases. Arterial spin labeling (ASL) MRI offers a noninvasive method to assess these changes. This systematic review consolidates evidence on the impact of hypertension on CBF using ASL-MRI. A comprehensive search across PubMed, Scopus, Embase, and Web of Science, following PRISMA 2020 guidelines, included studies on adults with hypertension reporting CBF measurements. Findings indicate that hypertension reduces CBF in various brain regions, with improvements seen after antihypertensive treatment. ASL-MRI may be a valuable tool for monitoring treatment effectiveness and brain health. However, most studies were conducted in high-income countries and elderly populations, emphasizing the need for further research in younger and low-income settings. Early CBF assessment using ASL-MRI could aid in timely interventions.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149503","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":"Retinal capillary rarefaction is associated with the systemic immune-inflammatory index in patients with hypertension.","authors":"Revathy Carnagarin, Shaun Frost, Eve Martin, Janis M Nolde, Louise Woodhams, Lakshini Y Herat, Justine Chan, Anu Joyson, Dennis Kannenkeril, Marcio G Kiuchi, Leslie Marisol Lugo-Gavidia, Markus P Schlaich","doi":"10.1097/HJH.0000000000004151","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004151","url":null,"abstract":"<p><strong>Objective: </strong>Rarefaction in capillary density is a hallmark of hypertension-mediated microvascular damage. This study aimed to assess the association between clinically accessible inflammatory markers, including the systemic immune-inflammation index (SII), and retinal capillary density, as well as other indicators of microvascular damage.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of data from 132 consecutive patients with established primary hypertension at the Royal Perth Hospital's tertiary hypertension clinic. All patients underwent noninvasive optical coherence tomographic angiography (OCT-A) for the assessment of retinal capillary density in the foveal region (CDF) and blood sampling for inflammatory markers. We examined the association of the SII - calculated as the product of the neutrophil-lymphocyte ratio and platelet count - and its individual components with retinal capillary rarefaction and other markers of microvascular damage, such as the urinary albumin-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). The results were adjusted for relevant co-variates, including age, sex, 24-h SBP, BMI, antihypertensive medications, lipid levels, and diabetes status.</p><p><strong>Results: </strong>Retinal capillary rarefaction was associated with increased white cell count, particularly neutrophils, and the SII. Through predictive margin analysis, an optimal cut-off value of 600 x 109/l for SII was determined for median CDF of 34.1 mm2. The analysis showed a reduction in CDF of 1.3 mm2 for every 250 x 109/l increase in SII. Additionally, higher SII levels (≥ 600 x 109/l) were associated with elevated high-sensitivity C-reactive protein (hs-CRP) levels and markers of microvascular damage, such as increased UACR and reduced eGFR.</p><p><strong>Conclusion: </strong>In patients with primary hypertension, SII and related inflammatory markers were associated with retinal rarefaction and renal indices of microvascular damage. SII may serve as a useful clinical marker of microvascular damage in the retinal and renal vascular bed.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212902","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":"Circulatory phenotypes in hypertension identified by 24-h ambulatory blood pressure monitoring.","authors":"Dagnovar Aristizábal-Ocampo, Diego Álvarez-Montoya, Camilo Madrid-Muñoz, Ricardo Fernández-Ruiz, Jaime Gallo-Villegas","doi":"10.1097/HJH.0000000000004149","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004149","url":null,"abstract":"<p><strong>Background: </strong>Although 24-h ambulatory blood-pressure monitoring (ABPM) is widely available, its diagnostic potential beyond confirming different types of hypertension remains under-utilized.</p><p><strong>Objective: </strong>To derive and externally validate against echocardiographic hemodynamic indices a purely ABPM-based classification of circulatory phenotypes that extends conventional blood-pressure staging.</p><p><strong>Methods: </strong>We retrospectively analyzed 29 743 consecutive adults who underwent 24-h ABPM. After excluding anyone previously treated for hypertension, 12 876 de-novo participants (50.2 ± 13.6 years; 51.4% men; 24.7% obese) were included, 9195 of whom were hypertensive. Pearson correlation matrices identified diastolic blood pressure (DBP), pulse pressure (PP) and heart rate (HR) as the least-collinear variables. These were z-standardized and submitted to K-means clustering.</p><p><strong>Results: </strong>Four reproducible phenotypes were yielded: cardiogenic - elevated HR and cardiac output (CO) without arterial dysfunction (ΔHR = +10.5 bpm vs. normotensives, 95% CI 10.0-10.9); vaso-resistive - raised DBP with reduced HR, resulting in a higher DBP/HR index (ΔDBP/HR = +0.23 mmHg bpm-1, 95% CI 0.22-0.24); mixed - simultaneously increased HR and DBP, giving the highest DBP/HR index (P < 0.001 vs. normotensives); arterial-stiffness - widened PP with lower DBP, reflected in an elevated PP/DBP index (ΔPP/DBP = +0.16, 95% CI 0.15-0.17). Cluster-derived proxies of CO, systemic vascular resistance, and arterial stiffness showed good agreement with echocardiographic measurements, confirming their physiological validity.</p><p><strong>Conclusions: </strong>A simple, unsupervised cluster analysis of routine ABPM data uncovers four reproducible circulatory phenotypes that enrich traditional blood pressure staging. Incorporating these phenotypes into clinical practice could refine risk stratification and enable mechanism-targeted antihypertensive therapy.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212924","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":"Higher systemic vascular resistance in individuals with a family history of hypertension.","authors":"Emmi K H Värri, Johanna Tietäväinen, Lauri J Suojanen, Manoj Kumar Choudhary, Jukka Mustonen, Jenni K Koskela, Ilkka H Pörsti","doi":"10.1097/HJH.0000000000004133","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004133","url":null,"abstract":"<p><strong>Objective: </strong>To compare blood pressure (BP) and cardiovascular function between individuals with and without a family history of hypertension in a first-degree relative.</p><p><strong>Methods: </strong>The haemodynamics of participants with (n = 437) and without (n = 274) a family history of hypertension were recorded using continuous tonometric pulse wave analysis and whole-body impedance cardiography during passive head-up tilt.</p><p><strong>Results: </strong>The group with a family history of hypertension had a higher percentage of antihypertensive medication users (15.6 vs. 8%, P = 0.003) and higher office BP (143/91 vs. 140/87 mmHg, P < 0.05) than the group without hypertensive first-degree relatives. The proportion of men (51.9 vs. 55.1%) and the mean age (48.2 vs. 48.1 years) were similar in both groups. During head-up tilt, participants with a family history of hypertension consistently had 5/4 mmHg (systolic/diastolic) higher radial and aortic BP (P < 0.001 for all comparisons), a shorter aortic reflection time (-2.4 ms, P = 0.017), and a higher systemic vascular resistance (SVR) index (180 dyn s/cm5 m2, P < 0.001) than participants without hypertensive first-degree relatives. Central forward wave amplitude, pulse pressure, augmentation pressure, augmentation index, heart rate, cardiac output, and pulse wave velocity did not differ between the study groups. All haemodynamic variables changed significantly in response to head-up tilt with no differences between the two study groups.</p><p><strong>Conclusion: </strong>Participants with a family history of hypertension were characterized by elevated central and peripheral BP probably due to higher SVR, whereas the stiffness of large arteries was not higher. These findings highlight the role of SVR in the pathogenesis of primary hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149484","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":"Novel homozygous pathogenic variant in HSD11B2 as a cause of apparent mineralocorticoid excess.","authors":"Ana Roche-Gomez, Cristina Julia Blázquez Gómez, Alejandra Licero Villanueva, Mar Espino Hernández","doi":"10.1097/HJH.0000000000004159","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004159","url":null,"abstract":"<p><p>Apparent mineralocorticoid excess is an extraordinarily rare autosomal recessive disorder, with less than 100 cases reported to date. This monogenic disorder, due to dysfunction of the 11-beta-hydroxysteroid type 2 enzyme, is characterized by severe hypertension and hydroelectrolytic disorders. The initial suspicion and diagnosis of this disease are crucial for targeted treatment, thereby improving the prognosis of these patients and minimizing complications.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212961","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":"Reclassification of patients with normal blood pressure levels after 2024 European society of cardiology guidelines on hypertension.","authors":"Giuliano Tocci, Giulia Nardoianni, Barbara Pala, Barbara Citoni, Agostino Virdis, Maria Lorenza Muiesan, Guido Grassi, Emanuele Barbato, Massimo Volpe","doi":"10.1097/HJH.0000000000004140","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004140","url":null,"abstract":"<p><strong>Introduction: </strong>In 2024, the European Society of Cardiology (ESC) guidelines proposed a new classification of elevated blood pressure (BP) and hypertension.</p><p><strong>Aim: </strong>To evaluate how many individuals with optimal, normal, and high-normal BP, as defined by the 2023 European Society of Hypertension (ESH) guidelines, would be reclassified as not-elevated or elevated BP, according to the new ESC guidelines.</p><p><strong>Methods: </strong>In this single-center, observational, retrospective, cohort study, we included adult individuals who were consecutively evaluated for home, office, and ambulatory BP measurements, and global cardiovascular risk stratification. All patients underwent BP measurements using a validated, oscillometric, automatic device (Mobil-O-Graph PWA Monitor, I.E.M. GmbH, Stolberg, Germany). Only untreated individuals with office BP levels <140/<90  mmHg and without comorbidities were considered for the analysis. Selected population was stratified according to 2023 ESH (optimal BP, <120/<80  mmHg; normal BP, 120-129/80-84 mmHg; high-normal BP, 130-139/85-89  mmHg) and then reclassified according to 2024 ESC guidelines (not-elevated BP, <120/<70  mmHg; elevated BP, 120-139/70-89 mmHg). Home and 24-h ambulatory BP levels were also evaluated in each category, when available.</p><p><strong>Results: </strong>We analysed 1230 adult untreated individuals with valid office BP levels, among whom 89.0% also had ambulatory and 42.6% home BP data, respectively. According to 2023 ESH guidelines, 262 (21.3%) individuals had optimal, 375 (30.5%) normal, and 593 (48.2%) high-normal BP levels; according to 2024 ESC guidelines, 87 (7.1%) had nonelevated, and 1143 (92.9%) had elevated BP. Compared to 2023 ESH guidelines, 66.8% individuals with optimal BP, and all individuals (100.0%) with normal and high-normal BP levels were reclassified as elevated BP by adopting 2024 ESC guidelines. This shift is more evident in women than in men (67.2 vs. 65.8%; P < 0.001).</p><p><strong>Conclusion: </strong>According to 2024 ESC guidelines, most individuals with optimal, and all those with normal and high-normal BP levels, as defined by 2023 ESH guidelines, are reclassified in the elevated BP category.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212877","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":"Arterial hypertension-attributable mortality in Europe, 2012-2021.","authors":"Marco Zuin, Alberto Mazza, Alessandro Maloberti, Chiara Tognola, Giovanbattista Desideri, Claudio Borghi, Pier Luigi Temporelli","doi":"10.1097/HJH.0000000000004148","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004148","url":null,"abstract":"<p><strong>Objectives: </strong>Comprehensive and updated assessments of arterial hypertension (HTN)-attributable mortality trends across Europe are limited. We evaluated the HTN-attributed mortality trends in Europe between 2012 and 2021, examining variations by age, sex, and European region.</p><p><strong>Methods: </strong>We extracted heart failure-attributed mortality data from the WHO mortality dataset for 2012-2021. Age-adjusted mortality rates (AAMRs) were analyzed using joinpoint regression modeling, expressed as average annual percentage change (AAPC) with 95% confidence intervals (CIs). A parallelism test compared trend differences across groups.</p><p><strong>Results: </strong>From 2012 to 2021, 1 658 592 individuals (773 129 men and 885 463 women) died due to HTN, equating to 3932.3 deaths per 100 000 population. Overall, the AAMR increased (AAPC: +1.6%; 95% CI: 1.2-2.1; P < 0.001), without significant differences between sexes (P for parallelism 0.38). HTN-attributable mortality trend had a higher increase among patients aged 70 or older compared to those aged less than 70 years (P for parallelism 0.007). Regionally, AAMRs increase in Northern (AAPC: +0.7%; 95% CI: 0.1-1.3; P = 0.002) and Eastern (AAPC: +2.79%; 95% CI: 1.8-3.6; P < 0.001) while plateaued in Western and Southern Europe (AAPC: -0.5%; 95% CI: -1.2 to 10.2; P = 0.09). Disparities in hypertension-attributable mortality were observed among countries.</p><p><strong>Conclusion: </strong>HTN-attributed mortality in Europe increased between 2012 and 2021. Substantial disparities persist across European regions and countries.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212913","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":"Defining abnormal flow-mediated slowing of brachial-radial pulse wave velocity, a noninvasive vasoreactivity test.","authors":"Hanne Van Criekinge, Marie Renier, Elise Decorte, Jomme Claes, Matthijs Michielsen, Youri Bekhuis, Evangelos Ntalianis, Everton Santana, Tatiana Kuznetsova, Véronique Cornelissen, Nicholas Cauwenberghs","doi":"10.1097/HJH.0000000000004146","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004146","url":null,"abstract":"<p><strong>Objectives: </strong>Flow-mediated slowing (FMS) reflects macrovascular reactivity by quantifying the decline in brachial-radial pulse wave velocity (PWV) during reactive hyperaemia. We identified abnormal FMS response using normal values and integrative algorithms.</p><p><strong>Methods: </strong>In this cross-sectional, observational study, 408 community-dwelling individuals underwent FMS testing with 5 min of upper arm occlusion. FMS was assessed at 30 s intervals for 4 min postocclusion. From 76 healthy individuals, we extracted limits of normality for peak FMS, defining an abnormal peak response if PWV slowed by less than 9.4% (if <60 years) or 4.6% (if ≥60 years). Group-based trajectory modelling (GBTM) assigned participants to distinct FMS response groups. Multivariable regression identified clinical correlates of the FMS response groups.</p><p><strong>Results: </strong>Higher age correlated independently with less decline in PWV in the early phase (P ≤ 0.0076 for 0-30 s), whereas higher SBP and no beta blocker use were linked to less decline overall (SBP: P ≤ 0.048 for 0-210 s; beta blockers: P ≤ 0.014 for 0-180 s). Abnormal peak FMS was associated with higher SBP [adjusted odds ratio (OR): 1.31, P = 0.0017) and less use of beta blockers (adjusted OR: 0.44, P = 0.041). A three-group GBTM model identified a low, moderate and high FMS response group. The risk for a low FMS response increased with age, SBP and no use of beta blockers (P ≤ 0.038 for all).</p><p><strong>Conclusion: </strong>Abnormal FMS response was linked to cardiovascular risk factors such as ageing, hypertension and beta blocker use. The FMS response patterns may enable qualitative interpretation of FMS tests, though validation against hard clinical outcomes is warranted.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199644","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":"Betaine protects cerebral microvascular endothelium and ameliorates hypertension-induced cognitive dysfunction via upregulation of the endothelial nitric oxide synthase/nitric monoxide signaling pathway.","authors":"Jiale Sun, Wenjuan Zhang, Xueying Wang, Xiaomin Zhao, Shan Gao","doi":"10.1097/HJH.0000000000004085","DOIUrl":"10.1097/HJH.0000000000004085","url":null,"abstract":"<p><strong>Objectives: </strong>Hypertension-induced endothelial damage in cerebral microvessels is a key factor contributing to vascular cognitive impairment (VCI). Endothelial function stabilization considerably depends on the endothelial nitric oxide synthase (eNOS)/nitrogen monoxide (NO) pathway. Furthermore, the eNOS/NO signaling pathway plays a role in stabilizing the vascular endothelium. Although betaine (bet) has been shown to improve cognitive dysfunction, its underlying mechanisms remain unclear. Therefore, this study aimed to determine whether betaine protects cognitive function by regulating eNOS/NO activity.</p><p><strong>Methods: </strong>Male 7-month-old spontaneously hypertensive rats (SHR) were randomly assigned to four groups: SHR, Bet, Bet and N(G)-Nitroarginine methyl ester hydrochloride (L-NAME), and L-NAME groups. Male 7-month-old Wistar Kyoto rats (WKY) served as controls. All animals received treatment or saline for 4 weeks. In-vitro experiments were conducted using rat brain microvascular endothelial cells (RBMECs) treated with either homocysteine (Hcy) or betaine. Behavioral experiments, western blotting, pathological tissue staining, Doppler ultrasound technique, and ELISA were employed to assess the impact of hypertension on cognitive and endothelial functions.</p><p><strong>Results: </strong>Hypertension led to cognitive decline in SHR by causing endothelial dysfunction, blood-brain barrier disruption, inflammation, oxidative stress, and apoptosis. Bet administration significantly improved these pathological indicators of cognitive impairment; however, the eNOS inhibitor L-NAME reversed its effects.</p><p><strong>Conclusion: </strong>Our findings suggest that betaine protects vascular endothelium and improves VCI by modulating the eNOS/NO signaling pathway.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1529-1538"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325973","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}

{"title":"Automated office blood pressure measurement: a Hypertension Australia and National Hypertension Taskforce of Australia position statement.","authors":"James E Sharman, Aletta E Schutte, Mark R Nelson, Ania L Samarawickrama, Nigel Stocks, Charlotte M Hespe, Tim Usherwood, Michael Stowasser, Anthony Rodgers, Natalie C Ward, Elizabeth Halcomb, Sharon James, Garry Jennings, Markus P Schlaich","doi":"10.1097/HJH.0000000000004079","DOIUrl":"10.1097/HJH.0000000000004079","url":null,"abstract":"<p><p>Hypertension is the most common problem managed in Australian general practice, yet most adults with hypertension do not have their blood pressure (BP) treated to target. Hypertension diagnosis and management rely upon accurate BP measurements performed using a standardised protocol. However, health system barriers prevent doctors from following measurement protocols, leading to inaccurate BP assessments. A practical BP measurement protocol that can be widely implemented is urgently warranted. Automated office BP (AOBP) is the recommended measurement standard for the diagnosis and management of hypertension. AOBP involves using a validated automated upper-arm cuff BP device programmed to record multiple BP readings at set intervals starting after a rest period. It is done by a trained operator using a standardised protocol in a quiet setting with the correct patient setup, no distractions, and in the absence of a doctor. The device automatically calculates the average of the AOBP recordings and this is comparable to the 24-h ambulatory BP daytime mean. The hypertension threshold based on AOBP is 135/85 mmHg. AOBP can also be applied in other community settings (e.g. pharmacies), provided all the above criteria are met along with communication of results to the person's usual general practitioner. In Australia, nation-wide systematic implementation of evidence based AOBP measurement is strongly recommended. This standardised approach will support healthcare professionals, especially general practitioners, in obtaining high-quality BP values with increasing confidence in clinical decision-making. Policy and practice changes, to address barriers and provide enabling mechanisms for sustained implementation of AOBP, are required.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1463-1472"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325972","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}