Journal of Hypertension最新文献

{"title":"Optimizing hypertension management: the impact of drug class, socioeconomic factors, and simplified regimens on medication adherence. VATAHTA study.","authors":"Nicolás F Renna, Eliel Ivan Ramirez, Sergio Vissani, Beder Gustavo Farez, Belén Camaño, Martha Alcorta, Emiliano Raul Diez, Jesica Magalí Ramirez","doi":"10.1097/HJH.0000000000004023","DOIUrl":"10.1097/HJH.0000000000004023","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence is essential for managing hypertension, yet many patients fail to follow prescribed treatments. This study examines the relationships between drug class, treatment complexity, socioeconomic factors, and adherence in hypertensive patients from Argentina.</p><p><strong>Methods: </strong>A multicentre, cross-sectional study was conducted with 1144 hypertensive patients from the Cuyo region. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8). The impact of drug classes, number of prescribed drugs, dosing frequency, and socioeconomic factors (education, home ownership, employment status) on adherence was analysed using multivariate logistic regression. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated.</p><p><strong>Results: </strong>Patients on fixed-dose combinations demonstrated better adherence than those on monotherapy (OR 1.30, 95% CI: 1.15-1.45). Higher education (OR 1.20, 95% CI: 1.05-1.35) and home ownership (OR 1.15, 95% CI: 1.02-1.28) were associated with improved adherence, while unemployment was linked to reduced adherence. Patients taking more than three drugs showed lower adherence (OR 0.85, 95% CI: 0.75-0.95), and more frequent dosing (more than twice daily) was linked to reduced adherence (OR 0.78, 95% CI: 0.68-0.90). Beta-blockers (OR 2.5, 95% CI: 2.0-3.0) and potassium-sparing diuretics (OR 1.7, 95% CI: 1.3-2.1) were associated with the highest adherence, while ACE inhibitors such as ramipril (OR 0.75, 95% CI: 0.60-0.90) were linked to lower adherence.</p><p><strong>Conclusion: </strong>Simplified regimens, particularly fixed-dose combinations, and the selection of drugs with favourable adherence profiles, like beta-blockers and potassium-sparing diuretics, can improve adherence. Addressing socioeconomic barriers should also be prioritized.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1191-1197"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023106","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":"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 cm3 versus ≥3.2 cm3). 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":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-27","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":"Triglyceride-glucose index and incidence of hypertension, a population-based observational study of the Japanese population.","authors":"Shintaro Ishida, Yukiko Shinohara, Takashi Sakaguchi, Shiori Katsuki, Kazumi Kawano, Tamami Ueno, Kaori Maki, Chihiro Nohara, Takako Fujii, Makiko Abe, Miki Kawazoe, Toshiki Maeda, Chikara Yoshimura, Kazuhiro Tada, Koji Takahashi, Kenji Ito, Tetsuhiko Yasuno, Shigeaki Mukobara, Kosuke Masutani, Hisatomi Arima","doi":"10.1097/HJH.0000000000004087","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004087","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to clarify the relationship between the triglyceride-glucose (TyG) index and the incidence of hypertension in a population-based sample of Japanese health check participants.</p><p><strong>Methods: </strong>We conducted a population-based retrospective cohort study using annual health checkup data from residents of Iki City, Nagasaki Prefecture, Japan. In total, 2600 participants without hypertension at baseline were included in the present analysis. The TyG index was classified as quartile1 (<8.08), quartile2 (8.09-8.43), quartile3 (8.44-8.84) and quartile4 (≥8.85) for men, and as quartile1 (<7.89), quartile2 (7.9-8.22), quartile3 (8.23-8.54) and quartile4 (≥8.55) for women. The outcome measure was the incidence of hypertension.</p><p><strong>Results: </strong>During an average follow-up period of 4.96 years, 789 participants developed hypertension using the Cox proportional hazards model. The annual incidence of hypertension increased with an increase in the TyG index in men (4.79% in quartile1, 6.25% in quartile2, 7.72% in quartile3, and 9.31% in quartile4) and women (3.65% in quartile1, 5.36% in quartile2, 5.55% in quartile3, and 6.96% in quartile4). This association was significant even after adjustment for other risk factors: hazard ratios 1.39 [95% confidence interval (CI) 0.99-1.93] for quartil2, 1.44 (1.03-2.01) for quartile3, 1.79 (1.27-2.52) for quartile4 relative to quartile1 among men (P = 0.001 for trend), 1.02 (95% CI 0.74-1.40) for quartile2, 1.04 (0.75-1.41) for quartile3, and 1.02 (0.74-1.42) for quartile4 relative to quartile1 among women (P = 0.882 for trend]).</p><p><strong>Conclusion: </strong>The TyG index was associated with the future incidence of hypertension in a population-based sample of Japanese men.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528274","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":"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":"https://doi.org/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":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postmeal walking reduces nighttime central SBP and increases nocturnal dipping of SBP in healthy, physically inactive young women.","authors":"Maison P D'Amelio, Ryan L Bonitatibus, Bilal A Chaudhry, John G Dennett, Deborah L Feairheller, Michael S Brian","doi":"10.1097/HJH.0000000000004082","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004082","url":null,"abstract":"<p><strong>Introduction: </strong>Postmeal walking (PMW) blunts postprandial blood glucose, but the impact on postexercise hypotension and ambulatory blood pressure (BP) has not been examined in young women. Further, it remains unknown how PMW influences ambulatory central BP among young women.</p><p><strong>Methods: </strong>Fourteen physically inactive, nonhypertensive women (20 ± 1 years; body fat: 28.1 ± 12%) completed the study during the early follicular or placebo phase of their contraceptive cycle. Participants completed a control day (CON; no exercise/excess physical activity) and PMW day (three bouts for 15 min of brisk walking). Ambulatory brachial and central BP (24 h, daytime, nocturnal, postexercise BP, nocturnal dipping) and accelerometry data were collected.</p><p><strong>Results: </strong>PMW reduced 24 h central augmentation pressure (PMW = 9 ± 4 mmHg; CON=10 ± 5 mmHg, P = 0.049) and central pulse pressure (PMW = 31 ± 3 mmHg; CON=33 ± 4 mmHg, P = 0.02). PMW also reduced nighttime central augmentation pressure (PMW = 10 ± 4 mmHg; CON = 13 ± 4 mmHg, P < 0.001) and central pulse pressure (PMW = 35 ± 5 mmHg; CON = 32 ± 3 mmHg, P = 0.001). PMW induced postexercise hypotension (effect of time: P < 0.05), but there was no effect of condition (P > 0.05 vs. CON), as the CON postprandial state also induced a hypotensive effect. PMW increased heart rate (main effect of condition, P = 0.01). PMW also increased brachial SBP nocturnal dipping (PMW = 17.5 ± 4.2; CON = 14.4 ± 5.2%, P < 0.05) and central SBP nocturnal dipping (PMW = 6.8 ± 4.5; CON = 12.2 ± 5.3%, P < 0.01). Brachial and central DBP nocturnal dipping was not different between conditions (PMW = 23.7 ± 5.9%, CON = 22.3 ± 7%, P = 0.50; PMW = 25 ± 6.4%, CON = 21.9 ± 5.6%, P = 0.13, respectively).</p><p><strong>Conclusion: </strong>PMW exerts the greatest influence on nighttime SBP and nocturnal dipping of SBP in young women. PMW also induces a similar hypotensive response that occurs following a meal.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475618","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":"Prevalence, awareness, and risk factors affecting hypertension according to 2017 American College of Cardiology and American Heart Association guidelines: a cross-sectional study from a developing country.","authors":"Imad Asmar, Omar Almahmoud, Maram Jaghama","doi":"10.1097/HJH.0000000000004089","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004089","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HTN) is a chronic disease prevalent worldwide, with a significant increase in the number of people diagnosed with HTN. This study aimed to determine the prevalence and awareness of HTN among adults in Palestine according to the 2017 American College of Cardiology and American Heart Association guidelines, and to investigate the risk factors affecting HTN.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between August 2024 and November 2024 among residents of West Bank Palestine. A total of 1420 adults aged 18 years and older were recruited using convenience sampling. Data were collected through blood pressure and anthropometric measurements of BMI and waist circumference. A questionnaire was used to gather sociodemographic information, HTN history, physical activity, antihypertensive drug use, and other family history information. Statistical analyses, including chi-square tests and binary logistic regression, were performed.</p><p><strong>Results: </strong>The prevalence of HTN in this study was 60%. Moreover, 46.4% of participants with HTN were unaware of their condition. Several factors were found to be independent predictors of HTN, including smoking [adjusted odds ratio (aOR): 8; 95% confidence interval (CI): 5.1-11.1], older age (aOR: 1.022; 95% CI: 1.01-1.04), and living in urban areas (aOR: 1.9; 95% CI: 1.4-2.5). Conversely, normal BMI (aOR: 0.6; 95% CI: 0.4-0.9) and moderate physical activity (aOR: 0.6; 95% CI: 0.6-0.8) were protective against the development of HTN.</p><p><strong>Conclusion: </strong>Three out of five adults in Palestine had HTN, and approximately half of them were unaware of their condition. The study findings indicate the urgent need for appropriate public health interventions to address awareness, early detection, and modifiable risk factors, which will greatly alleviate the regional HTN burden.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475619","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":"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":"https://doi.org/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":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-23","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":"Genome-wide association study of angiotensinogen levels and key single nucleotide polymorphism associations with blood pressure.","authors":"Karita C F Lidani, Shubham Tomar, Hossein Mousavi, Robert Buscaglia, Kirolos Michael, Alexander P Landry, Leonie Dupuis, Erin D Michos, Erin S Morgan, Xiuqing Guo, Jie Yao, Henry J Lin, Jerome I Rotter, Wendy S Post, Sotirios Tsimikas, Patrick J Trainor, Andrew P Defilippis","doi":"10.1097/HJH.0000000000004080","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004080","url":null,"abstract":"<p><strong>Objective: </strong>The renin angiotensin aldosterone system plays a key role in circulatory homeostasis. We sought to identify genetic determinants of measured plasma angiotensinogen levels and subsequently evaluate the association of these single nucleotide polymorphisms (SNPs) with blood pressure (BP) and hypertension in a multiethnic population.</p><p><strong>Methods: </strong>Genome-wide association study (GWAS) of plasma angiotensinogen levels, measured using an enzyme-linked immunoassay, was conducted in 4899 Multi-Ethnic Study of Atherosclerosis (MESA) participants (self-identified as White, n = 1865; Hispanic, n = 1113; Black, n = 1224; and Chinese, n = 629). Linear and logistic models examined the association between SNPs with angiotensinogen and hypertension, respectively. Mediation analysis evaluated the effect of angiotensinogen on BP/hypertension through the top SNPs identified by GWAS.</p><p><strong>Results: </strong>In the analysis utilizing all participants, 115 SNPs were associated with angiotensinogen (P < 5 × 10-8), including lead SNP rs4762(G>A) in exon 2 (P = 1.51E-100) and rs5050(T>G) in the promoter region (P = 2.26E-69) of the AGT gene. Race/ethnic-specific analyses identified rs4762(G>A) as the lead SNP for White and Hispanic participants, whereas Black and Chinese participants had rs5050(T>G) and rs16852311(G>C), respectively. Both rs4762(G>A) and rs5050(T>G) indirectly increased systolic BP, diastolic BP, and the odds of hypertension through its effect of increasing angiotensinogen.</p><p><strong>Conclusions: </strong>Our findings demonstrate racial/ethnic differences in genetic effects on angiotensinogen levels across multiple SNPs. AGT rs4762(G>A) and rs5050(T>G) impact BP and hypertension through a mediated effect via angiotensinogen, though opposing direct effects may mask the overall association.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475606","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":"LASSO logistic regression and cluster analysis in predicting adherence and drug patterns among new users of monotherapy for antihypertensive drugs.","authors":"Xuechun Li, Mutiara Djayanis Tia, Jens H J Bos, Catharina C M Schuiling-Veninga, Eelko Hak, Sumaira Mubarik","doi":"10.1097/HJH.0000000000004084","DOIUrl":"10.1097/HJH.0000000000004084","url":null,"abstract":"<p><strong>Objective: </strong>Real-world long-term adherence and drug utilization patterns are essential for hypertension management. However, the evidence was unclear. We aimed to construct adherence and drug patterns risk prediction models.</p><p><strong>Methods: </strong>We designed a retrospective inception cohort study using pharmacy records from the University of Groningen IADB.nl dispensing database. Exposures were antihypertensive drug monotherapy including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, beta-blockers, calcium channel blockers, and thiazides. Primary outcomes included adherence rates and drug utilization patterns. Cluster analysis was performed to categorize patients with similar risk factors. Least Absolute Shrinkage and Selection Operator logistic regression was then employed to construct prediction models.</p><p><strong>Results: </strong>The adherence rate in the 1st year to the 10th year increased from 86.4% to 92.9%. Most monotherapies, middle and older age, with initial diabetes, asthma/ chronic-obstructive-pulmonary-disease drug, and without psycholeptics drug, first exposure prescription after 2000 promoted high adherence. Thiazides and being male were harmful to continuation and helpful to discontinuation, switching and adding on. Middle and older age promoted switching and adding on but impeded discontinuation. High adherence contributed to continuation, switching and adding on but impeded discontinuation. Thiazides were better for the short term use to achieve high adherence while calcium channel blockers in both short term and long term were better to achieve high adherence than beta-blockers.</p><p><strong>Conclusions: </strong>The results highlighted key factors influencing medication adherence and treatment changes, emphasizing the need for personalized approaches to optimize patient care. Enhancing adherence and provide specific monotherapy for short term and long term plan were beneficial to better personalized treatment.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368946","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":"A steep-increasing blood pressure trajectory from early pregnancy is associated with birth outcomes in the EDEN mother-child cohort.","authors":"Briana DeStaffan, Muriel Tafflet, Grégory Lailler, Valérie Olié, Jacques Blacher, Catherine Deneux-Tharaux, Marie-Aline Charles, Barbara Heude, Wen Lun Yuan","doi":"10.1097/HJH.0000000000004083","DOIUrl":"10.1097/HJH.0000000000004083","url":null,"abstract":"<p><strong>Background: </strong>An enhanced consideration of blood pressure (BP) dynamics during pregnancy could improve its monitoring. Distinct BP trajectories may exist, and some have been linked to adverse fetal development. Using maternal BP measurements spanning almost the entire pregnancy, this study aimed to identify trajectories and assess their association with birth outcomes.</p><p><strong>Methods: </strong>Routine BP measurements (median = 8) were extracted from the obstetric records of 1849 mothers from the French EDEN birth cohort. Outcomes included birth weight z-score, prematurity and, for a subsample (n = 1377), placental weight and birth weight-to-placental weight ratio. Maternal SBP trajectories were identified by Latent Class Growth Mixture Modeling. Associations with outcomes were analyzed using adjusted linear or logistic regressions.</p><p><strong>Results: </strong>Two BP trajectories were identified: a first U-shaped and a second steep-increasing, comprising 96 and 4% of mothers, respectively. The steep-increasing trajectory reached the hypertensive threshold around 30 weeks of gestation. Over half of mothers in this trajectory had a hypertensive disorder diagnosis, and 24% had preeclampsia. Mothers in this trajectory had newborns with lower birth weight z-scores [β = -0.31, 95% confidence interval (95% CI) = -0.55 to -0.07] and/or increased likelihood of premature delivery (odds ratio = 4.02, 95% CI = 2.04-7.50). No associations were observed with placental outcomes.</p><p><strong>Conclusion: </strong>Our results suggest the existence of a steep-increasing BP trajectory from the first weeks of pregnancy and associated with poorer birth outcomes. Further investigation into this trajectory's determinants could lead to improved hypertensive disorder risk stratification, ultimately aiding in the prevention of related maternal and fetal consequences.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368945","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}