Journal of Hypertension最新文献

{"title":"Associations of high-density lipoprotein cholesterol, particles and subspecies with the risk of hypertension: findings from the PREVEND prospective study.","authors":"Setor K Kunutsor, Margery A Connelly, Ashish Shah, Stephan J L Bakker, Robin P F Dullaart","doi":"10.1097/HJH.0000000000004014","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004014","url":null,"abstract":"<p><strong>Objective: </strong>The prospective associations of high-density lipoprotein cholesterol (HDL-C), HDL particle (HDL-P) and subspecies concentrations with the risk of hypertension are uncertain. We aimed to evaluate the associations of HDL parameters with incident hypertension risk and their interplay with alcohol consumption in the PREVEND study.</p><p><strong>Methods: </strong>HDL parameters as measured by nuclear magnetic resonance spectroscopy and self-reported alcohol consumption were assessed in 3263 participants (mean age, 49 years; 45.8% males) without a history of hypertension at baseline. Multivariable-adjusted hazard ratios (HRs) with 95% CIs for hypertension per 1 standard deviation increment in HDL parameters were calculated.</p><p><strong>Results: </strong>During a median follow-up of 7.2 years, 825 participants developed hypertension. In analysis adjusted for several potential confounders, including alcohol consumption, there were inverse associations of HDL-C, HDL-P, medium HDL, HDL size, H3P and H4P with hypertension risk: HRs [95% confidence interval (CI) of 0.88 (0.81-0.97), 0.92 (0.86-0.99), 0.86 (0.80-0.93), 0.89 (0.82-0.98), 0.92 (0.85-0.98), and 0.87 (0.81-0.94), respectively]. Sex or alcohol consumption did not modify the associations of HDL parameters with hypertension risk. Compared with abstainers, the multivariable adjusted HRs (95% CI) of hypertension for occasional to light, moderate and heavy alcohol consumers were 0.84 (0.70-1.00), 0.83 (0.68-1.02), and 0.97 (0.69-1.37), respectively; the associations persisted on further adjustment for HDL parameters.</p><p><strong>Conclusions: </strong>There are inverse associations of HDL-C, HDL-P, medium HDL, HDL size, H3P and H4P with hypertension risk, which are not confounded or modified by alcohol consumption. Light and moderate alcohol consumption is modestly and inversely associated with hypertension risk, independently of HDL parameters.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743229","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 treatment with soluble guanylate cyclase stimulator BAY41-8543 prevents malignant hypertension and associated organ damage.","authors":"Martina Hüttl, Matúš Miklovič, Olga Gawryś, Matěj Molnár, Petra Škaroupková, Zdeňka Vaňourková, Soňa Kikerlová, Hana Malínská, Petr Kala, Zuzana Honetschlägerová, Janusz Sadowski, Lenka Hošková, Peter Sandner, Vojtěch Melenovský, Miloš Táborský, Michal Šnorek, Luděk Červenka","doi":"10.1097/HJH.0000000000004009","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004009","url":null,"abstract":"<p><strong>Objective: </strong>Despite availability of an array of antihypertensive drugs, malignant hypertension remains a life-threatening condition, and new therapeutic strategies for the treatment of malignant hypertension and malignant hypertension-associated organ damage are needed. The aim of the present study was to assess the effects of nitric oxide (NO)-independent soluble guanylyl cyclase (sGC) stimulator on the course of malignant hypertension. The second aim was to investigate if the treatment with sodium-glucose cotransporter type 2 (SGLT2) inhibitor would augment the expected beneficial actions of the sGC stimulation on the course of malignant hypertension.</p><p><strong>Methods: </strong>As a model of malignant hypertension, Ren-2 transgenic rats (TGR) treated with nonspecific NO synthase inhibitor (Nω-nitro- l-arginine methyl ester, l-NAME) was used. Blood pressure (BP) was monitored by radiotelemetry, and the treatment was started 3 days before administration of l-NAME.</p><p><strong>Results: </strong>The treatment with sGC stimulator BAY 41-8543, alone or combined with SGLT2 inhibitor empagliflozin, abolished malignant hypertension-related mortality in TGR receiving l-NAME. These two treatment regimens also prevented BP increases after l-NAME administration in TGR, and even decreased BP below values observed in control TGR, and prevented cardiac dysfunction and malignant hypertension-related morbidity. The treatment with the SGLT2 inhibitor empagliflozin did not further augment the beneficial actions of sGC stimulator on the course of malignant hypertension-related mortality.</p><p><strong>Conclusion: </strong>The treatment with NO-independent sGC stimulator displayed marked protective actions on the course of malignant hypertension-related mortality and malignant hypertension-related cardiac damage. This suggests that application of sGC stimulator could be a promising therapeutic means for the treatment of malignant hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803512","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":"Effect of telemonitoring and home blood pressure monitoring on blood pressure reduction in hypertensive adults: a network meta-analysis.","authors":"Shubhima Grover, Hara Prasad Mishra, Rachna Gupta, Lalit K Gupta","doi":"10.1097/HJH.0000000000004008","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004008","url":null,"abstract":"<p><strong>Introduction: </strong>Telemonitoring and home blood pressure monitoring (HBPM) are becoming popular approaches for managing hypertension. They are believed to improve patient compliance as compared to the usual care monitoring. This network meta-analysis was undertaken to compare blood pressure (BP) reduction following telemonitoring, HBPM and usual care BP monitoring approaches.</p><p><strong>Methods: </strong>PubMed and clinicaltrial.gov were searched till 15 May 2024 for randomized controlled trials (RCTs) comparing telemonitoring, HBPM and usual care monitoring for reduction in BP and the postintervention BP in hypertensive adults.</p><p><strong>Results: </strong>A network meta-analysis with 24 RCTs was performed using MetaInsight. Telemonitoring produced a significantly greater reduction in the systolic blood pressure (SBP) (-3.69 mmHg [95% CI -5.82; -1.57, P < 0.001]) and the diastolic blood pressure (DBP) (-1.82 mmHg [95% CI -2.98 to -0.67, P < 0.001]) as compared to the usual care monitoring. Home BP monitoring also produced a greater lowering of SBP (-2.73 mmHg [95% CI -5.69 to 0.22, P = 0.069]) and DBP (-2.09 mm Hg [95% CI -3.66 to -0.52, P < 0.001]) than usual care, with a significant reduction in the DBP alone. The postintervention SBP and DBP were also lower in the telemonitoring and the HBPM groups than the usual care group. However, there was no significant difference between the SBP and the DBP reductions in the telemonitoring and the HBPM groups.</p><p><strong>Conclusion: </strong>Telemonitoring and HBPM may be more useful in controlling BP as compared to usual care management alone. However, more direct studies comparing telemonitoring with HBPM are needed in the future.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a single session of low- and high-intensity velocity-based resistance exercise on blood pressure in patients with hypertension.","authors":"Luis A Benavides-Roca, Germán Parra, Antonio R Zamunér","doi":"10.1097/HJH.0000000000004015","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004015","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effects of high and low-intensity velocity-based resistance exercise on blood pressure in individuals with hypertension.</p><p><strong>Methodology: </strong>A crossover clinical trial was performed. Thirty-three participants with diagnosis of hypertension took part in the study. Participants underwent two sessions of resistance training: low-intensity, characterized by 12 repetitions and 6 sets at 40% of one-repetition maximum velocity; high-intensity, characterized by 6 repetitions and 6 sets at 80% of one-repetition maximum velocity. A 1-week washout was considered between the sessions. Participants were randomly assigned to exercise intensity at the first session. Blood pressure was measured by an automated device before and immediately after both sessions. 24-h ambulatory blood pressure monitoring (ABPM) was performed after the sessions. Significance level was set at 5%.</p><p><strong>Outcomes: </strong>The results showed that low-intensity resistance exercises significantly decreased systolic (≈5 mmHg), diastolic (≈4 mmHg) and mean arterial blood pressure (≈4 mmHg), which was not observed after the high-intensity exercise. No significant differences were found between exercise sessions for the post 24-h ABPM.</p><p><strong>Conclusion: </strong>Low-intensity resistance exercise was more effective in decreasing blood pressure in patients with hypertension than a high-intensity protocol.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743233","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":"https://doi.org/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":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-27","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":"Predictive value of pulmonary to systemic vascular resistance ratio in systemic lupus erythematosus patients with pulmonary arterial hypertension.","authors":"Xiaoxiao Guo, Junyan Qian, Jinzhi Lai, Hui Wang, Zhuang Tian, Qian Wang, Jiuliang Zhao, Xiaofeng Zeng, Mengtao Li, Yongtai Liu","doi":"10.1097/HJH.0000000000004010","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004010","url":null,"abstract":"<p><strong>Objective: </strong>Pulmonary arterial hypertension (PAH) is a serious complication of systemic lupus erythematosus (SLE) with high mortality. The ratio of pulmonary to systemic vascular resistance (SVR) (Rp : Rs) may increase with disease progression. However, the prognostic value of Rp : Rs in predicting the outcomes of patients with SLE-PAH remains to be elucidated.</p><p><strong>Methods: </strong>Between 1 February 2012, and 30 June 2022, consecutive patients with a diagnosis of SLE-PAH and minimum one follow-up were enrolled prospectively. The end points were all-cause mortality and lung transplantation. The predictive values of baseline clinical characteristics and hemodynamic parameters, including Rp : Rs, were analyzed using Cox proportional hazard analyses. C-statistics were used to compare the predictive ability between the models.</p><p><strong>Results: </strong>A total of 285 patients were included and followed up for a median duration of 3.41 (interquartile range 1.81-5.72), during which 58 (20.4%) patients reached the endpoint. Multivariable Cox regression analysis revealed that in addition to the 6-minute walk distance (6MWD), the Rp : Rs was an independent predictor of the endpoint [hazard ratio 24.72; 95% confidence interval (CI) 5.59-109.29, P < 0.001] in predicting the endpoint. The concordance index for a model incorporating the Rp : Rs and the 6MWD yielded a value of 0.75 (95% CI 0.68-0.82), which showed better predictive accuracy than the simplified risk stratification strategy. Introducing the Rp : Rs ratio to the 2022 ESC/ERS four-stratum model significantly improved its predictive performance for these patients.</p><p><strong>Conclusion: </strong>The Rp : Rs serves as an independent predictor of adverse prognosis in patients with SLE-PAH and could provide additional value over current risk-assessment tools.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663674","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":"Assessing causal relationships between gut microbiotas, metabolites, and pulmonary arterial hypertension through univariate Mendelian randomization study and bioinformatics analysis.","authors":"Dongrui Xu, Hong Liu, Jiankang Yang","doi":"10.1097/HJH.0000000000004003","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004003","url":null,"abstract":"<p><strong>Background: </strong>Recent research has linked gut microbiotas and metabolites to the development and progression of pulmonary arterial hypertension (PAH) through the gut-lung axis. However, current studies on the causal relationship between gut microbiotas, gut microbiota derived metabolites, and PAH lack conclusive evidence. This study employed Mendelian randomization and bioinformatics analysis to reveal the possible causal links among them.</p><p><strong>Methods: </strong>Summary statistics of gut microbiotas, metabolites, and PAH were from GWAS. Univariate Mendelian randomization (inverse variance weighted and weighted median), reverse Mendelian randomization, and verification through other PAH GWAS cohorts were used to analyze the possible causal relationships between these gut microbiotas or gut microbiota derived metabolites and PAH. In addition, Cochran's Q statistic, MR-Egger regression intercept, MR-PRESSO global test, and the leave-one-out method were used for the sensitivity analysis. Based on this, we carried out an initial bioinformatics analysis to investigate its potential biological mechanisms.</p><p><strong>Results: </strong>Preliminary screening of the present research revealed four gut microbiotas (Genus Eubacteriumfissicatenagroup, Genus RuminococcaceaeUCG002, Genus Tyzzerella3, and Genus Sutterella) and one metabolite (taurolithocholate 3-sulfate) correlated with PAH. However, after validation in other PAH GWAS cohorts, only genetically increased Genus Tyzzerella3 (odds ratio: 0.54, 95% confidence interval: 0.37-0.80, P = 0.0018) correlated with a reduced risk for PAH, a relationship may be related to the keratan sulfate and glycosphingolipid synthesis. No significant heterogeneity, pleiotropy, or reversal causation effect was observed (P > 0.05).</p><p><strong>Conclusion: </strong>Our Mendelian randomization analysis establishes a significant correlation between Genus Tyzzerella3 and PAH, positioning it as a prominent protective factor for PAH.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663672","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":"Long-term cardiovascular repercussions in women with previous pregnancies complicated by severe hypertensive disease.","authors":"Renata Gomes Sanches Verardino, Thiago de Andrade Macedo, Sara Rodrigues, Valéria Costa Hong, Fernanda Spadotto Baptista, Maria Rita de Figueiredo Lemos Bortolotto, Rossana Pulcineli Vieira Francisco, Luiz Aparecido Bortolotto","doi":"10.1097/HJH.0000000000003999","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003999","url":null,"abstract":"<p><strong>Objective: </strong>To assess the long-term functional and structural repercussions of the heart and vessels in women with a history of severe preeclampsia (PE).</p><p><strong>Methods: </strong>A cross-sectional study conducted at a tertiary hospital involving women 2-5 years postpregnancy, divided into three groups: isolated preeclampsia (de novo PE = 30), superimposed PE and/or chronic hypertension (PEs/HC= 60), and normal gestation (NG = 30). We evaluated age, body mass index (BMI), office systolic (SBP) and diastolic blood pressure (DBP), 24-h ambulatory blood pressure monitoring (ABPM), noninvasive central blood pressure (CBP) by tonometry (sphygmocor), pulse wave velocity (PWV - complior), and echocardiography (ViviDI-GE).</p><p><strong>Results: </strong>Age (38 ± 5 years) and BMI (32.6 ± 6 k/m2) were higher in PEs/HC. Office SBP (mmHg) was higher in de novo PE (124.8 ± 11) and PEs/HC (133.6 ± 19) than NG (114.6 ± 9), and DBP (mmHg) was higher in PEs/HC (87.8 ± 12) than NG (73.3 ± 8) and de novo PE (80.4 ± 12). ABPM showed higher SBP in all periods for PEs/HC than NG and de novo PE. Central SBP was higher in PEs/HC and De novo PE compared to NG and De novo PE. Carotid-femoral PWV (m/s) was higher in PEs/HC (8.1 ± 2) than NG (6.8 ± 1) and de novo PE (7.0 ± 1). Echocardiography revealed increased septal thickness and left atrial diameter in PEs/HC, with a higher left ventricular (LV) mass index in de novo PE and PEs/HC than NG.</p><p><strong>Conclusion: </strong>Women with previous de novo PE have higher office and central blood pressure values and greater ventricular mass compared to those with previous normal pregnancies. The most significant cardiovascular repercussions were observed in women with previous superimposed PE or chronic hypertension during pregnancy.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663673","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":"Long-term event rates, risk factors, and treatment pattern in 1.4 million individuals qualifying for dual blood pressure lowering therapy.","authors":"Antonio Coca, Claudio Borghi, George S Stergiou, Nelly Francoise Ly, Christopher Lee, Aurore Tricotel, Anna Castelo-Branco, Irfan Khan, Jacques Blacher, Mohamed Abdel-Moneim","doi":"10.1097/HJH.0000000000004002","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004002","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed rates of cardiovascular events, all-cause death, baseline risk factors, and treatment patterns in a population qualifying for initiation of dual combination blood pressure (BP)-lowering therapy. We also evaluated the association between dual versus monotherapy during follow-up and incidence of cardiovascular events.</p><p><strong>Methods: </strong>This study utilized integrated databases in England: Clinical Practice Research Datalink, Hospital Episode Statistics, and Office for National Statistics. Individuals aged at least 18 years qualifying for dual therapy were identified during 15-year period (2005-2019). The primary endpoint was composite of nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, and cardiovascular death. The secondary endpoint was all-cause death.</p><p><strong>Results: </strong>Total 1 426 079 individuals met selection criteria. The 15-year event rates for the primary and secondary endpoints were 27.1 and 32.6%, respectively. Atherosclerotic cardiovascular disease, diabetes on insulin therapy, heart failure, atrial fibrillation, chronic kidney disease, and advanced age were associated with two to four-fold higher risk of primary and secondary endpoints. The estimated hazard ratio for dual versus monotherapy as a time-varying covariate was 0.82 (95% confidence interval 0.81-0.83) for the primary endpoint. At variance with guidelines, monotherapy was most common treatment pattern over 5-year follow-up.</p><p><strong>Conclusion: </strong>Baseline characteristics conveying a multifold higher risk for cardiovascular events and all-cause death mostly represented nonmodifiable risk factors. Treatment with dual therapy as compared to monotherapy was associated with reduction in cardiovascular events. Monotherapy remained most common BP-lowering treatment indicating substantial opportunity for risk reduction by treatment intensification.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657317","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 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":"https://doi.org/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 m2, and the LVMI was 134 ± 48 g/m2, with a 62% prevalence of LVH. Our adjusted models revealed that a decrease in eGFR by 1 ml/min/1.73 m2 predicted an increase in LVMI of 1.12 g/m2 (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":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-10","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}