Journal of Hypertension最新文献

{"title":"Cerebral small vessel disease and effects of intensive versus standard blood pressure treatment on cardiovascular outcomes and adverse events.","authors":"Mallika Reddy, June Li, Nicholas M Pajewski, Sarah A Gaussoin, R Nick Bryan, Ilya M Nasrallah, Manjula Kurella Tamura","doi":"10.1097/HJH.0000000000004093","DOIUrl":"10.1097/HJH.0000000000004093","url":null,"abstract":"<p><strong>Objectives: </strong>The safety of intensive blood pressure lowering in patients with preexisting cerebral small vessel disease (CSVD) remains unclear.</p><p><strong>Methods: </strong>We used data from 759 participants in Systolic Blood Pressure Intervention Trial (SPRINT) who completed a baseline MRI, and categorized participants by the median abnormal white matter hyperintensity volume (WMHv, <3.2 cm 3 versus ≥3.2 cm 3 ). We estimated the association of the baseline WMHv with cardiovascular outcomes and adverse events using Cox proportional hazards models adjusted for treatment assignment, age, sex, MRI scanner, and intracranial volume. We used stratified analysis to determine the effect of intensive versus standard treatment by the baseline WMHv.</p><p><strong>Results: </strong>The mean age of the participants was 68 ± 9 years and 39% were female. In adjusted models, adults with WMHv above the median had an increased risk of the primary cardiovascular composite outcome [hazard ratio (HR) 2.59, 95% confidence interval (CI) 1.39, 4.81], all-cause mortality (HR 2.06, 95% CI 0.97, 4.37), and mild cognitive impairment or probable dementia (HR 1.76, 95% CI 0.99, 3.13). While the effects of intensive versus standard blood pressure treatment were similar for most outcomes by WMHv, intensive treatment was associated with a higher risk for mild cognitive impairment or probable dementia among adults with a WMHv above the median (HR 2.36, 95% CI 1.20, 4.66), but not among adults with a WMHv below the median (p-value for interaction = 0.09).</p><p><strong>Conclusions: </strong>In this posthoc analysis of SPRINT, adults with a higher WMHv were at a higher risk for adverse cardiovascular and cognitive outcomes. Among these adults, intensive blood pressure treatment reduced cardiovascular events, while its effects on the risk of cognitive impairment or dementia in this subgroup merit further study.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1582-1588"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528273","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":"Efficacy and safety of sacubitril/valsartan in Afro-descendant patients with resistant hypertension: a randomized controlled trial.","authors":"Yasmin de Souza Lima Bitar, André Rodrigues Durães, Cristiano Ricardo Bastos de Macedo, Marcela Gordilho Aras, Levi Cardozo Santos, Rogério Smith Freire de Abreu, Enilson Carmo Barbosa Dos Santos, Edimar Bocchi, Wallace Andre Pedro da Silva, Roque Aras Junior","doi":"10.1097/HJH.0000000000004075","DOIUrl":"10.1097/HJH.0000000000004075","url":null,"abstract":"<p><strong>Background: </strong>Sacubitril/valsartan (Sac-Val) has demonstrated blood pressure (BP)-lowering effects, but its role in resistant hypertension remains unclear. This study evaluated the efficacy and safety of Sac-Val compared to optimized angiotensin II receptor blocker (ARB) or angiotensin-converting enzyme inhibitor (ACEI) therapy in Brazilian patients with resistant hypertension, predominantly Afro-descendant.</p><p><strong>Methods: </strong>In this phase III, 8-week, single-center, randomized trial, 80 adults with resistant hypertension were assigned to Sac-Val (titrated to 200 mg with an optional increase to 400 mg if BP remained >140/90 mmHg) or standard therapy (ARB/ACEI combined with other antihypertensive agents). The primary endpoint was the proportion of patients achieving BP control (<140/90 mmHg). The co-primary endpoints included mean reductions in mean sitting SBP (msSBP), mean sitting DBP (msDBP), and mean sitting pulse pressure (msPP) at week 8. Secondary outcomes assessed dose-dependent BP reduction.</p><p><strong>Results: </strong>BP control was achieved in 94.9% of patients in the Sac-Val group versus 69.2% in the control group ( P  = 0.03). Sac-Val significantly reduced msPP (-6.05 mmHg, P  = 0.008) and showed a trend toward greater msSBP reduction ( P  = 0.06). The 400 mg dose resulted in the greatest BP reduction, particularly for msPP ( P  = 0.034). No deaths were reported.</p><p><strong>Conclusion: </strong>Sac-Val was more effective than standard therapy in achieving BP control and reducing BP in resistant hypertension, with a dose-dependent trend favoring the 400 mg regimen. These findings support Sac-Val as a potential treatment alternative for high-risk Afro-descendant patients.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1485-1491"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575632","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":"Combined percutaneous renal artery denervation and angioplasty: still too early to consider them complementary?","authors":"Fortunato Iacovelli, Luigi Salemme, Rocco Tritto, Sebastiano Cicco, Filippo Masi, Loreto Gesualdo, Marco Matteo Ciccone","doi":"10.1097/HJH.0000000000004078","DOIUrl":"10.1097/HJH.0000000000004078","url":null,"abstract":"<p><p>In case of renovascular hypertension, percutaneous renal artery transluminal angioplasty alone is still far from demonstrating predictable clinical results. Assuming a potential synergistic effect, we reported the first case of combined percutaneous renal denervation and angioplasty as intention-to-treat strategy in a very high cardiovascular risk patient.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1598-1601"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325974","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":"Goal blood pressure in hypertension: the game of numbers. A perspective.","authors":"Vito M Campese","doi":"10.1097/HJH.0000000000004066","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004066","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 9","pages":"1475-1477"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742269","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":"In Memoriam Stevo Julius, MD, ScD.","authors":"Jana Brguljan Hitij, Paolo Palatini, Bojan Jelakovic, Sverre E Kjeldsen, Giuseppe Mancia, Anthony Heagerty","doi":"10.1097/HJH.0000000000004073","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004073","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 9","pages":"1604-1605"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742271","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":"Causal role of the gut microbiota in pulmonary arterial hypertension: insights from Mendelian randomization.","authors":"Wei Wu, Guo-Liang Huang, Jia Cui","doi":"10.1097/HJH.0000000000004081","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004081","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 9","pages":"1602"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742266","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":"Treating hypertension with single pill combinations: a simple strategy to save costs for the patients and payers.","authors":"Miriam Pikkemaat, Emily R Atkins, Anthony Rodgers, Aletta E Schutte","doi":"10.1097/HJH.0000000000004050","DOIUrl":"10.1097/HJH.0000000000004050","url":null,"abstract":"<p><strong>Objectives: </strong>Our aim was to compare direct costs for single pill combinations (SPCs) and free-drug combinations for hypertension treatment.</p><p><strong>Methods: </strong>We focused on Australia as a case study and reviewed total costs, and for the patient and government. We reviewed the Australian \"Pharmaceutical Benefits Scheme item drug map\" considering different thresholds for the government safety net. Total costs included medicine costs and pharmacy fees.</p><p><strong>Results: </strong>For patients, SPCs always cost less than free-drug combinations, with greatest savings for general patients before reaching safety net (averaging 30%). For government, SPCs cost on average less than free-drug combinations, for Concession Card holders both before (averaging 11%) and after reaching safety net (averaging 26%) and in general patients after safety net (averaging 11%). There was a slight increase in costs (16%) for the government for patients before reaching safety net. All findings were driven by savings in dispensing fees, the main cost of supply, also after the recent introduction of 60-day dispensing.</p><p><strong>Conclusion: </strong>Single pill combinations, instead of free-drug combinations, result in cost saving for both patient and government in almost all cases and often these savings are large. SPC cost savings should be factored into prescribing decisions, both for people receiving multiple pills and people starting treatment.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1478-1484"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325954","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":"Interplay of gut microbiome and metabolome in various blood pressure phenotypes based on ambulatory BP monitoring reveal new insights in nondipper patients.","authors":"Deniz Aral Ozbek, Neriman Sila Koc, Nese İnal, Sevilay Erdogan Kablan, Yunus Kaygusuz, Sevilay Karahan, Oğuz Abdullah Uyaroğlu, Tolga Yildirim, Koray Ergunay, Emirhan Nemutlu, Yakut Akyon, Bulent Altun","doi":"10.1097/HJH.0000000000004086","DOIUrl":"10.1097/HJH.0000000000004086","url":null,"abstract":"<p><strong>Objective: </strong>Accumulating evidence has shown an association between stool microbiome and hypertension. However, gut microbiome and metabolome of nondipping blood pressure (BP), high BP variability and morning BP surge have not been extensively studied. Here, we aimed to investigate the interplay between the gut microbiome, metabolome and 24-h urine sodium (Na) levels in different BP phenotypes.</p><p><strong>Methods: </strong>This study included 45 newly diagnosed hypertensive, and healthy participants. Ambulatory BP monitoring was performed in all patients to confirm the diagnosis and determine corresponding BP phenotypes. Gut microbiome and metabolome were determined using 16S ribosomal RNA sequencing and gas chromatography-mass spectrometry, respectively.</p><p><strong>Results: </strong>Firmicutes / Bacteroides ratio was higher in nondipper than dipper group ( P  = 0.01). Comparative analyses showed that 23 species, 21 genera and 9 families were significantly differentiated in different BP phenotype subgroups. Functional metabolomic enrichment analysis of nondipper patients showed enrichment of catecholamine biosynthesis and tyrosine metabolism due to noradrenaline, dopamine, 3,4-dihydroxyphenylglycol and 3,4-dihydroxyphenylacetic acid. Spearman analyses between significantly enriched metabolites and organized taxonomic units (OTUs) in nondipper patients showed correlations between 3,4-dihydroxyphenylglycol and Parabacteroides diastonis (rho = -0.33, P  = 0.03) and dopamine with Chryseobacterium genus (rho = 0.71, P  = 0.02). Enterococcus, Lachnobacterium, Odoribacter and Pseudomonas were positively, whereas Lactobacillus and Clostridium were negatively correlated with urine Na levels.</p><p><strong>Conclusion: </strong>We revealed novel relationships among gut microbiome, metabolome and sodium intake in different BP phenotypes. Enrichment of catecholamine synthesis and correlations between OTUs and metabolites in nondipper patients indicated that sympathetic system activation via gut-brain axis could play a role in the nondipping BP profile.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1539-1553"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475617","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":"Regional structural differences in the brain related to high blood pressure.","authors":"Donggyu Rim, Tye Dawood, Rania Fatouleh, Brendan McCarthy, Gianni Sesa-Ashton, Annemarie Hennessy, Markus Schlaich, Luke A Henderson, Vaughan G Macefield","doi":"10.1097/HJH.0000000000004091","DOIUrl":"10.1097/HJH.0000000000004091","url":null,"abstract":"<p><strong>Objective: </strong>Hypertension is characterized by elevations in sympathetic nerve activity that are consistently observed regardless of severity and treatment status. Structural changes in the brain occur with hypertension, including grey matter changes, which are associated with elevated blood pressure (BP). However, whether or not these changes are associated with increased sympathetic nerve activity in hypertensives has not been investigated. The present study aimed to determine the relationship between regional grey matter density, muscle sympathetic nerve activity (MSNA) and BP in people with hypertension, compared to normotensive participants.</p><p><strong>Methods: </strong>T1-weighted anatomical scans (3T MRI) were acquired from 35 hypertensive and 57 normotensive participants; MSNA was successfully obtained from the right peroneal nerve in 26 hypertensives and 55 normotensives. Voxel-based morphometry (VBM) analysis was conducted to determine regional grey matter density and the relationships between MSNA and BP in both groups.</p><p><strong>Results: </strong>An inverse relationship between MSNA and grey matter density was found in the left dorsolateral prefrontal cortex, right precentral gyrus, left superior parietal lobule, and right cuneus in hypertensives but not in normotensives. In addition, hypertensive participants showed a negative correlation between grey matter density and DBP in the right precentral gyrus and left postcentral gyrus, which was not observed in controls.</p><p><strong>Conclusion: </strong>We have shown an association between specific nuclei of the brain with elevated MSNA and BP in hypertension. These findings suggest a functional link between grey matter density in specific brain nuclei and MSNA and BP in patients with hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1570-1581"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475620","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":"Erratum: Immune microenvironment profiling of primary aldosteronism.","authors":"","doi":"10.1097/01.hjh.0001125888.50180.e9","DOIUrl":"https://doi.org/10.1097/01.hjh.0001125888.50180.e9","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 9","pages":"1603"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742267","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}